ļ»æHealing Migraines Naturally
Dr. Leslie Cisar
Recording 0233 | Edited transcript | 36:12
[00:00]
Hi there, welcome to the Healing Migraines Naturally podcast. I'm your host, Dr. Leslie Cisar, and I'm a licensed naturopathic doctor, former chronic migraine sufferer, and I've dedicated my life to helping other women with chronic migraines rediscover a migraine-free life. Today on the podcast, we're going to jump right into it. I have failed you. That's what a neurologist said to a woman I talked with on a consult call a couple of weeks ago.
[00:33]
Not, "You failed the treatment." Not, "You're overusing your medication." Not, "Let's try one more thing. I have failed you." I haven't been able to stop thinking about that sentence because the woman that neurologist said it to could have been me. If I'd filled one prescription back in the mid-90s, that would have been my story. And if you've had migraines for a long time, I think it's probably your story too. So today I'm going to tell you her story the way she told it to me.
[01:08]
Listen like you're on the call with us. So I do free consult calls with women who are thinking about working with me. The first few minutes are just, you know, getting to know each other. Where do you live? What do you do? Who's at home? She's in her late 30s. She works full-time, long days on her feet. She's married. She's got two kids. Her life is full. And then I ask the question.
[01:38]
I ask everybody, "What was the tipping point? Why are you reaching out now?" And she says, "Well, I've kind of been at a tipping point and I just haven't really figured out where to turn." And then she tells me the whole thing. She says, "I've had migraines as long as I can remember really, probably since the age of like 16 or so. They started about a year or two after her first period.
[02:04]
Bad headaches in high school. She'd take ibuprofen or Excedrin from her mom's medicine cabinet and then go to class. Nobody thought too much of it. Teenage girls get headaches, right? By college, it was bad enough that she needed a prescription." Her words. "I remember I had to have triptans in college." So she gets her first triptan, imitrex. And it works. The first one usually does. That's how most of these stories start.
[02:35]
Something works and you think, "Okay, I've got this handled. I'd rather not take medication, of course, but if I only have to take this occasionally, it's better than suffering and missing class, laying in bed, and so on." And then she graduates. She starts working. She gets married. She has her first baby and then her second. And the migraines keep coming and they keep coming more often. Now, by her late 30s, she's getting three to four migraines a week.
[03:07]
Three to four a week. That's half her life. She tells me, "I think twice in my life I've gone two weeks without a migraine." And she says, "One of those times I was so sick, like with a cold, and somehow I ended up going a couple weeks without a migraine. I don't even know how." She said it like it was a piece of trivia. Like, "Isn't that funny? I wrote it down.
[03:38]
We'll come back to it." Then she starts on the medications and she says, "I have tried everything." And when women tell me they've tried everything, they usually mean it. She meant it. The triptans. The imitrex works for a while. Then it doesn't work as well. So what do they do? They switch her to Maxalt. Then that doesn't work as well. So they switch her to Relpax. She tells me that the migraine comes back every 24 hours almost to the hour after she takes one.
[04:04]
So what do they do? They move her to Frova. Frova triptan because it lasts longer in the body than the other triptans. Its half-life is about a day, so it holds the migraine off longer. But her insurance only covers nine per month and she's getting three to four migraines a week. Do the math. She runs out. So now every migraine comes with a complication. I call it the head check. You wake up and before you open your eyes, you're checking.
[04:40]
"Is it there? How bad is it? What do I have on the docket today? Should I burn one of my Frova? Can I get by with an excedrin? What am I doing on the weekend? Am I going to need a stockpile? Am I going to need more to do that thing on Sunday?" She knows exactly how many are left in that bottle on any given day, and I know a lot of you do too.
[05:02]
Now we go to the preventatives. In her words, "I've been on every preventative, literally every single one." propranolol, a beta blocker. It made her so tired she could hardly get through the day. Remember, her work is a very physically demanding job. Topamax. If you've been on Topamax, you know the tingling in your fingers, the reaching for a word in the middle of a sentence, and it's not there. They don't call it Topamax for no reason.
[05:34]
The only route she wouldn't go was the antidepressants. She just wasn't comfortable with that, and so her neurologist didn't push. In her words, "I hated all of them. I'm very sensitive to medication and side effects." I hear this all the time. Women with migraines are very sensitive to medications. We're cutting the pills in half. We're asking for the lowest dose. We're the ones that get the one in a million side effect, and then the neurologist said, "I've never had anyone react that way, and they're so shocked."
[06:14]
Well, we're not shocked. We've been there before. That sensitivity is a clue. We're going to get to it. And then Botox. Every 12 weeks, she goes in and gets 31 injections across her forehead, her temples, the back of her head, and her neck, and her shoulders. She says, "Botox helped me a little bit. All that for a little bit." Eventually, she stopped, and she didn't notice a difference. So at this point in her timeline, we got the new drugs coming out, the CGRP injections, the monthly shots, Aimovig, Ajovy, Emgality.
[06:48]
And as she said, they worked great for a few months. Those were her words. Then she started breaking out in hives, allergic type reactions, so they had to take her off. By this time, now we've got the pills. So they switched her to Nurtec, the pill version of the injectables. And Nurtec worked for a few years. And then this past year, she started getting symptoms that she never had in her life.
[07:16]
A patch of dry, itchy skin on her elbows that won't go away. Bloating after every meal when she never had a stomach problem in her life. Her hair coming out in the shower. Some mornings, she's waking up stiff all over like she's 20 years older. And she tells me, "migraines have been my only health ailment. I've been very healthy. I eat very clean." So she goes down the rabbit hole. She starts reading.
[07:42]
She starts wondering what years of these medications have done to her body. She's got a theory. I'm not going to get into her theory, but I'll tell you, she's not wrong to wonder. And then once or twice a year, she gets a migraine that won't break. Nothing touches it. It backs off for 12 hours, but it's not really gone. We're doing more abortives. The only thing that breaks it is a steroid taper.
[08:13]
And not that long ago, she had one of the worst migraines of her life. And she did the steroids. And it was back the day after she finished them. Her word for it was "discouraging." That's a polite word. And of course, she's been told that she's in rebound, medication, overuse, headache. If you take a triptan on 10 or more days a month for more than three months, that's the definition of medication overuse.
[08:42]
Three to four migraines a week is 12 to 16 days a month. She's over the line, and she knows it. And her doctor's advice is, "Stop. Cold turkey." But look at her life. She's got a job where she can't hide in a cubicle. She's got two kids. She says, "I don't have a choice. I have to function. I can't just lay in bed." So the choice she's been given is be in rebound or be in bed.
[09:09]
Her words, "I feel like a ball and chain with the triptans." So she starts looking outside of her neurologist's office. Who could blame her? So she goes to the Cleveland Clinic. She waits months for the appointment. She takes time off work. She makes the trip. And she's hopeful because this is the big leagues. They're going to have testing her doctor doesn't have. They're going to know something her doctor doesn't know. They're going to have a drug that her doctor hasn't heard of.
[09:40]
And she sits down, and they go through the same list, same drugs, same order. Maybe they rearrange the combination. I've heard this story so many times. Women walk out of Cleveland Clinic, Mayo, the big university headache centers, and cry the whole way home. My client, Amanda, I did a whole episode with her, said exactly that. She left in tears and cried most of the way home because they told her the same thing her local neurologist told her.
[10:17]
It's not that these doctors are bad. It's that they're all working off the same checklist. So she goes natural. Again, who can blame her? She finds a chiropractic neurologist. She goes three times a week. She says it helped a little bit, but it wasn't anything life-changing. She does a food sensitivity test. She cuts out everything that came up. Soy and a bunch of foods that she ate all the time. She mostly cuts out gluten.
[10:46]
Now she's making her own sourdough at home. No real change. Then she orders one of those detox and cleanse kits because everybody's talking about it. Detox, detox, cleanse, cleanse. Every practitioner she sees or every advertisement that she sees on social media shows up with their answer. The chiropractor works with your spine. The food sensitivity test tells you not to eat certain foods. The supplement company with the cleanse kit, they show up with the cleanse.
[11:24]
And nobody asks why her body isn't recovering. Why her body is generating the migraines in the first place. And all along the way people are giving her advice. Just avoid your triggers. And she says well I can't because everything is a trigger. Noise, light, smells, the weather. It's literally everything. And then the big one. It'll get better at menopause. As she told me, that's horrible. Don't even tell me that. That's like 20 years away.
[12:05]
Now I didn't want to tell her at the time. She's about 39. It's not going to be 20, maybe 10 to 12. But that's what it feels like when you're getting three to four migraines a week. To tell a woman wait for menopause for you know 10 years, it feels like a 20 year sentence. I did a whole podcast episode on that advice for the women who took it and then waited and then didn't feel better.
[12:32]
And then she tells me about the last time she saw her neurologist. And I want to be fair to this neurologist because my caller was. She called her a very attentive, a great neurologist. She said she basically has tried everything under the sun to help me. This is a doctor who knows her, years of appointments. And at this last appointment, my caller tells her neurologist the truth. She says she feels like she can't help her anymore.
[13:10]
And the neurologist looks at her and says, "I have failed you." And then she says it again, "I have failed you." And when she told me this, my caller said, "It's sad." And then she kept, she kept going right into the next sentence, right into the next thing. And that's just what we do, isn't it? We don't stop. We've got a job and kids and a migraine tomorrow. We don't have time to stop.
[13:36]
And I didn't stop her either. I'll be honest with you on the call. I didn't say anything about it. She kept going and I went right along with her. But I've been thinking about it ever since. Oh, right now when she reached out to me, she stopped all of the preventatives. No more Botox, no more CGRP drugs. She's done. She says, "I just want to be done putting any pharmaceutical in my body."
[14:02]
The only thing she still takes is the Frova, because without it, she can't function. She's waking up at four in the morning with head pain. Even on a good day, she says, there's a, you know, a remote level of pain at all times. And she said something I wrote down word for word. When someone dangles a carrot in front of your face and gives you the hope of relief, you take it.
[14:26]
And eventually you just reach a point where you realize it's not working and it's actually causing harm. And then I asked her what her life would look like without migraines. And she said, I can't even imagine 23 years of migraines. And she can't picture her life without them. She said, I've pretty much gone the last several years feeling like this is never going to go away. That's what I have failed you confirms.
[14:51]
If the expert is out of answers, then this is just how this is going to be. So this is what I would say to her now. The neurologist was honest. First, I respect what that neurologist said. Think about the other things that she could have said. She could have said, you failed the treatment. Women are told that all the time when a medication stops working. Like it's a test that they didn't study for.
[15:23]
I talked about that back in episode two. She could have said, well, you shouldn't have taken so much medication like the rebound was her fault. I talked about that in episode 19. Or she could have written one more prescription. Let's give this a try. She didn't do any of that. She looked at her patient and she told her the truth as she saw it. And a lot of doctors wouldn't. But she got one thing wrong.
[15:51]
Who failed? The neurologist didn't fail. She did everything her training gave her to do. She went through every drug on the list in order, carefully, and she cared about her patient. And my caller didn't fail. She took the pills. She got the shots. She cut the foods. She drove to the clinic. What failed is the approach. Every single drug in this story does the same job. It stops the migraine. Some of them stop it once it starts.
[16:25]
Some of them try to stop it from starting. But not one of them asks, why is this body making a migraine three to four times a week? That's not a flaw in the drugs. That's what they were designed to do. Their suppressants. And they're very good at it for a while. And then the body adapts. The first triptan works and then it doesn't work as well. So you go to the next one and the next one and then you have to add a preventative and then a second preventative.
[17:00]
I talked about this in episode 19. That's not bad luck. That's the pattern. She lived every step of it. And underneath all of it is a belief that's taught in medical school. That a chronic condition is something you manage, not something you recover from. So when the list of drugs runs out, there's nothing left. From inside that model, the neurologist was right. She had nothing left to offer. She ran out of drugs.
[17:29]
That's not the same thing as running out of options. Now I want to ask the question, where is your needle? I did a whole episode on this, episode 74. But if you're new here, let me walk you through this at a high level. I want you to picture a compass. A compass needle. When that needle is pointing north, your body is in a state of health. Everything's in balance. There's an organizing energy to every living thing that keeps it that way.
[18:04]
And I picture that as a needle pointing north. Now all day long, stress is pushing that needle down. Physical stress, things like light hitting your eyes, a change in the barometric pressure, a bad night's sleep, digesting a meal. We don't think of these things as stressors, but they're physical stressors. And they're continuously bombarding us and pushing that needle down. And then there is mental and emotional stress, a fight with your husband, a deadline, worrying about tomorrow.
[18:43]
All of that pushes the needle down. And your own resiliency and vitality is what pushes the needle back up in the face of those stressors. Now around the dial are the symptoms and conditions that you're prone to. And a lot of that is inherited. Your dial isn't the same as mine. The same storm front rolls through and it pushes everybody's needle down. But one person's knees ache and another person gets anxious and you get a migraine.
[19:15]
It's the same stressor, but the dial is different. At the top near north are the early warning signs and symptoms. Things like seasonal allergies, heartburn, waking up at three in the morning worrying. Most people think that stuff is normal. It's not. It's your needle starting to slip. Migraines are around northwest. The further down you go, the worse the conditions are. If you keep going down past northwest, there are ones that do actual damage to your body, to your joints, your gut, your organs.
[19:58]
And south is death. We don't want to get anywhere near there. Wherever your needle gets stuck, that's what you live with as far as symptoms. Migraine sufferers. We know exactly where our needle is because a migraine is loud. You feel it the second your needle hits the edge of what I call your migraine zone. I call that the uh-oh moment. Uh-oh, something's brewing. Every one of you know what that feels like.
[20:25]
For me, the first time my needle is starting to slip, it's just starting to leave north, is my daughter. She's very happy. She's very active. She's very talkative. She's always in motion. And when my needle's up, that charms me. But when it starts to slip, it starts to irritate me. Then comes my actual uh-oh moment. When my needle has slipped even further and it's hovering right at the top of my migraine zone.
[20:53]
For me, it's this very strange feeling in my stomach, like it's suddenly empty and it needs to be filled. That's my uh-oh moment. And if my needle keeps slipping, then the head pain starts. My caller is getting three to four migraines a week. Her needle isn't dipping into her migraine zone every now and then. It's living there. So where does a triptan fit in on that dial? A triptan does not move your needle north.
[21:32]
It doesn't move it at all. If anything, it pushes it down a little bit further. All it does is make it harder for you to feel where your needle is stuck. It turns down the volume on the migraine, but it doesn't do anything about where your needle is. So her frova, three or four times a week, isn't moving her needle. It's hiding where her needle is. And it gets worse. Remember those new symptoms?
[22:01]
The skin, the bloating, the hair, the stiffness after years on Nurtec? What we call side effects, that in many cases is the needle falling further down the dial, further out of a state of health. And which side effects you get has a lot to do with what's on your dial. That's why two women can take the same drug and have completely different reactions. Nobody is doing that analysis. Her doctors are asking one question.
[22:29]
Did the migraine get better? Nobody is asking which way the needle moved. So it's not just that the medication stopped working. Her needle kept sliding down while she took them. And there's one more thing about the needle, and nobody knows to ask about it. When a symptom goes away, you have to ask why. Did it go away because your needle moved up towards north, past your migraine zone, or because it dropped down below?
[22:58]
Because you can be too sick to get a migraine. I've been there. In 2012, I got the flu. And as a result of some complications of that, I was diagnosed with Graves' disease. I was very sick. And for a while, I didn't get migraines. I was too sick to get migraines. My needle was pushed down even lower than my migraine zone. And as I got healthier, as my needle came back up, I went back through my migraine zone.
[23:35]
I had a stretch of migraines again on the way up. I've talked about this on the podcast. So if you start doing this work and you hit a hard stretch, that doesn't mean that you failed again. Sometimes that's what coming back up looks like. The way you tell the difference is to look at everything. If the migraines go away, but the heartburn is still there, the allergies are still there, the exhaustion is still there, your needle didn't go north.
[24:00]
When your needle really moves up, everything gets better. I always like to say a rising tide of health lifts all of the symptom boats. Now let's go back to I've tried everything. What she's actually tried is every medication and a handful of practitioners who each showed up with their answer already picked out. The spine, the food, the cleanse. What no one has done is ask what's blocking her body from recovering from getting that needle back up to north.
[24:42]
Not what can we give her, what's in the way. When I listen to her story, I listen for three things. I call them the three principles. These are the three things that our bodies need to move that needle up to north, to feel good, to be in a state of health, to not have symptoms, okay, like migraine or a whole host of other symptoms. Number one, is the body getting the nutrients that our cells need to the cells?
[25:08]
Is it clearing metabolic waste material and toxins, getting it out of the cells and eventually out of the body? And does it have the resiliency and vitality to bring that needle back up to north and keep it there even when we're being bombarded by all of these stressors all the time? So let's talk about nutrients to the cells. So she's eating clean. She's making her own sourdough. She's clearly putting a lot of effort into her eating habits.
[25:40]
She's checking all those boxes. So why isn't it showing up and how she feels, right? Eating good food. Yes, we have to eat health-supporting food. I don't think I'm going out on a limb. I think people are aware of that. We do have to eat food with nutrients in it, but can your digestive tract break your food down? Are you able to get those nutrients into your bloodstream and actually transport it to the cells, which is not just a random process of just diffusion?
[26:11]
And then can your cells actually bring the nutrients into the interior of the cell? That again, it just doesn't happen by diffusion. I'd want to know a lot about her digestion and other symptoms that indicate that her blood is not delivering those cells, especially after years of medications. The second principle, clearing waste material and toxins. Her migraine started a year or two after her first period when a young woman goes through puberty and starts menstruating, her body is suddenly creating a lot more metabolic waste.
[26:58]
That's when toxicity symptoms very commonly start to show up and that sensitivity to medications. Every one of those drugs is something her liver has to clear. A body that's already struggling to clear is a body that gets the one in a million side effect and she's still taking a triptan 12 to 16 days a month. Resiliency and vitality, our third principle, this is something that no one looks at. She's getting about five hours of sleep on her work nights.
[27:27]
She's pushing through three to four migraines a week because she has to. She's waking up at four in the morning doing the head check. That's a body running on empty. Three questions. Nobody she saw asked any of them. They just showed up with their toolkit. This is what I have for you. I have prescription medications. I have spinal adjustments and I've got a food sensitivity test and I've got a cleanse. I hope this is what you need because I'm not going to ask you.
[27:59]
Now, I want to go back to the cold. Remember that cold she got? Two weeks without a migraine. The one time she was sick and she has no idea why. Most people would hear that and think, "Hmm, weird. Maybe it was the cold medicine." I don't think so. Her needle didn't go up during that cold. Her body was fighting an infection and it didn't have enough vitality to fight the infection and make a migraine at the same time, so her body picked one.
[28:40]
I had a client a while back. I talked about her in episode 74. Her migraines eased up while she had a cold. Now, the easy thing would have been to say, "Oh, look. My recommendations are kicking in," but I knew her vitality was low, so I told her, "I think when the cold clears, the migraines are going to come back," and they did. What I said to her then, "Your body didn't have enough energy or vitality to do both things," and so it picked one over the other, and we want our body to fight the infection, so her body made a good decision.
[29:24]
When my caller tells me about the two-week period of time during the cold that she never got a migraine, this is not trivia. This is not a funny story. I hear that her body isn't broken. It's making good decisions with too little to work with. It's rationing, and vitality is the one thing that nobody touched. Every drug, every specialist, every test, the clinic, the chiropractor, the food test, the cleanse kit, all of it was aimed at the migraine, fighting the migraine.
[29:58]
Just because it's natural doesn't mean that it's not suppressive or fighting something. Nothing was aimed at what her body needs to come back up to North. Remember, a migraine going away isn't always good news. Sometimes your body is too sick to make one. That's why I always ask, "Which way did the needle move?" And, you know, this would have been my story on the call. I told her something that I've said on this podcast before.
[30:27]
I told her I have no doubt I'd be right in her situation had I taken the prescription my doctor wrote for me all those years ago. I told this story back on episode one. My migraine started when I was 24. I started to realize maybe these migraines weren't just happening to me. Maybe something was out of whack, and if I could figure out what it was, I could feel better. So I made an appointment with my medical doctor who I really liked.
[31:03]
I was so excited for this appointment. I was expecting a full workup, a half-hour, 45-minute appointment, and you can imagine what happened. 10 minutes and a prescription. I was legitimately confused, and I had a very strong intuitive knowledge that if I filled this prescription, I was going to be putting a band-aid on it, and I didn't want a band-aid. I wanted to get to the root and understand what was causing it, so I never filled the prescription.
[31:27]
And I thought, "Well, maybe she was just really busy that day." So I booked another appointment the next month. You can tell how young I was and naive I was, so I went back through the whole thing again the next month, and she said, "Well, I gave you a prescription last month. Did you fill it? Did you take it?" I said, "No," and she said, "Well, take the medicine." And I thought, "Well, let me try one more time, because, you know, this is what doctors do.
[31:57]
They restore the sick to health." So I went back a third time the next month, three months. Every month I was back there from three times. Nothing unapproved. I was still suffering, but then she got really irritated, and she said, "You haven't taken the medicine." She was notably irritated with me, and, you know, who could blame her? I was the one who didn't know what was actually going on here, and so she whipped out her prescription pad again, and she wrote me a prescription for a narcotic painkiller.
[32:29]
Now, this was the mid-90s. Doctors gave opiates for this kind of thing back then pretty regularly, and I have this memory seared into me, leaving the office, staring down at that prescription for an opiate pain medication, and that was the turning point for me. I knew if I took it, it would be a disaster. I just knew that intuitively, and that's when I started looking for real answers. I've talked to so many women over the years who got addicted to opiates because of these kinds of prescriptions, and I could have been one of them.
[33:07]
If I had filled that first prescription, I would have gone down the same road my caller did. The first one works, then it doesn't, then the next one, then the preventative. 25 years of it. That would have been my story. Let me tell you about Amanda again. When Amanda came to me in 2019, she had chronic migraines for nine years. Half the week, she had a migraine. She'd been through the triptans, one after another, each one working and then not.
[33:42]
She'd been on Topamax for a year and a half. She went to a specialty headache center and cried most of the way home because they told her the same thing her neurologist told her. They're hereditary, and you'll probably have them until menopause. Sound familiar? About four weeks into working together, she noticed a shift. Hard to name, but real, and from there, the migraines kept dropping. Now she's gone long enough between them that she can't remember when the last one was.
[34:16]
She tapered off her abortives and her preventatives working with her prescribing doctor. She said, "The migraines were really big in my life. That was like the biggest thing, and now they're the smallest thing." So to the woman whose neurologist said, "I have failed you. Your neurologist ran out of drugs. Your body didn't run out of the ability to recover. You haven't tried everything. You've tried every medication, and you've tried the natural version of the same thing, the same approach, a supplement instead of a prescription pill, a cleanse instead of a shot.
[34:58]
Each one of them was aimed at the migraine, and I know some of you are thinking, "Okay, here comes Dr. Leslie's cleanse." No, I don't start with an answer. I start with a question. Please don't spend the next two years looking for a bigger clinic with the same question, and don't spend the next 10 years waiting for menopause. There's a question nobody has asked your body yet. What's blocking your body from recovering?
[35:25]
And that question has an answer, and when you find it, it's going to tell you a lot more than any drug ever did. And if you're living with chronic migraines and you want to get an answer to that question, let's talk. I'd love to have you schedule a free consultation call just like this caller did. The link is in the description. We'll talk about your migraines and any other health conditions you have, and we'll put together a game plan to get you feeling better.
[35:59]
I'm telling you it's going to be the best 30 minutes you've spent on your health in a long time. Thanks so much for being here today. I'll talk to you soon.
