The holidays can be tough, and so can gifting! I don’t know about you, but in my family, we ask for exactly what we want so there’s no guesswork and everyone ends up happy campers. However, figuring out what would be a useful thing to receive can be difficult. So, I’ve put together this guide. Send it to your loved ones, or gift something to yourself! These ideas help decrease your trigger load and will help improve your quality of life with a vestibular disorder!
Avulux Glasses
I recently talked to the people at Avulux, and I am officially obsessed. They are the only brand of migraine glasses that has real third-party research backing them up! They filter out many wavelengths of light, not just blue light, that can be irritating for migraine and let through the green light that is soothing for migraine. They have research to show that wearing these glasses within an hour of a migraine can actually decrease the impact of your migraine and dull the pain without an abortive medication. They have options for prescription and non-prescription glasses, which is also a game-changer. Here’s a video on how it works. Code vertigodoc will get you $25 off your order!
Migraine Shields for Light Sensitivity
Migraine Shields are made by a vestibular migraine warrior for vestibular migraine warriors. They block the spectrum of blue light that people with migraine are sensitive to while letting some forms of blue light through – so things like sunlight and natural forms of light can get through, which is important for your circadian rhythm! You can use code vertigodoc20 for 20% off of your order!
Vitamins for Vestibular Dysfunction
Taking daily vitamins daily is essentially important for a vestibular disorder. My favorite vitamin company for people with vestibular dysfunction is Pure Encapsulations. They have very few additives and people do very well with them. However, if those are out of your price range, and you can tolerate Soybean oil (present in some vitamins), I’d recommend Nature Made Vitamins. If you or your loved one is in need of vitamins for Vestibular Migraine, that article can be found linked here. Vitamins and supplements are the first treatment for vestibular dysfunction very frequently, and research shows that they can really help decrease the symptoms – so it’s always worth a shot! But be sure to check in with your doctor first.
If you want to gift vitamins or supplements to a friend or family member, try subscribing to the vitamin on Amazon, that way you can get them a whole yea of vitamins and really take the stress out of ordering them monthly!
Vestibular Group Fit Subscription
Vestibular Group Fit is the only exercise and movement program based on your vestibular system. It intends to improve your physical strength, cardiovascular health, vestibular strength. VGF is the ONLY program created with your needs in mind. It accounts for dizziness, fitness levels, and difficult days where movement may feel impossible. It also includes premium content such as how to treat visual vertigo, navigating social situations, and more! You have the opportunity for 6 workouts per week, 3 of which are live classes. Come celebrate your body and movement with us!
The Dizzy Cook Cookbook
Alicia Wolf, the author of the Dizzy Cookbook, the absolute best when it comes to all things heal-your-headache diet. So many people with Vestibular Migraine respond incredibly well to altering their dietary needs. This book has more than the recipes you find on her blog, and she also has cute aprons and other products available! Check them out here.
Loops for Sound Sensitivity
If you, or your loved one, have sound sensitivity with migraine (or between attacks) Loops earplugs are your friends! They are specifically designed to decrease ambient noise, while letting you hear all other noises around you. You’ll be able to hear conversations around you, but the crowd noise will be blocked out – this is ideal for people who have hearing loss, hyperacusis, or difficulty paying attention to what their conversation partner is saying. Plus, they come in many colors, like silver, gold, black, roses gold, maroon, and more. And, the ear bud can be changed to meet the size of your ear, which is awesome!
Cefaly Device for Vestibular Migraine
The Cefaly device is very helpful for 
neuromodulation of migraine attacks. This has a preventative mode and an attack mode. You can read more about the Cefaly device, and other neuro-modulation devices here. The only one you can purchase over the counter is the Cefaly, and it’s a great one to try as they have a 90 day return period!
Allay Lamp
The Allay lamp is based on research that a specific wave of green light will help to decrease head pain and calm your brain during and between migraine attacks. If you are light-sensitive but need to get work done, the Allay Lamp is for you or your loved one! It emits a specific kind of green light that is calming – you can still get your work done without feeling the immense pain of bright lights during a migraine attack.
Norb Lightbulb
Norb lightbulbs are based on the same light technology that Allay Lamps and Avulux glasses use – green light is so calming! This light bulb can be placed into any lamp or light that holds a bulb. Itt will make the entire room green. They also have new research to show it helps with sleep!
Fatigue and exercise are a vicious cycle. This cycle often occurs when you do too much in one day, become exhausted, rest for a week, and exercise again. And the cycle repeats. Fatigue can happen for many reasons, many of which are due to a chronic illness. I understand that saying “you should just exercise more” to a person with chronic illness, and chronic fatigue is ableist, and I am not trying to preach that narrative. I will do my absolute best to explain how to exercise to prevent fatigue instead of triggering fatigue.
What is fatigue?
Fatigue is not being tired; it’s an entirely different feeling based on proper exhaustion. It is not because you haven’t slept enough, and no amount of coffee will make it better. Tired happens to everyone; we are tired after a hard workout, tired at the end of the day, and tired when we don’t sleep enough. Tired is not fatigue.
Fatigue is a constant and unrelenting form of exhaustion. Fatigue happens when our bodies cannot provide enough energy to function properly, let alone do our normal daily activities. This will ultimately lead to needing more rest than an average person and doing less movement overall. Our bodies love to move – we are meant to. But, if you can’t move as much as necessary, it leads to deconditioning.
Fatigue does not just come from being conditioned. Other chronic disorders, such as hypothyroidism/Hashimoto’s disease, chronic fatigue syndrome, myalgic encephalomyelitis, sleep apnea, POTS, kidney disease/organ failure, and other chronic illnesses can also be at the root cause of fatigue. However, most of these conditions, if there is too much rest involved, can lead to deconditioning, which is often the root of the issue.
What does Deconditioning Have to do With fatigue?
Deconditioning is a very complex physiological change in your body after a period of prolonged rest. This can happen as quickly as a week, but those losses are typically regained more easily. The deconditioning I am talking about occurs after months to years of not moving freely, walking, lifting, working out, or even consistently running errands. This will lead to a decrease in cardiovascular function, decreased muscle mass, and more.
Decreased muscle mass is what we are going to focus on here. A decrease in muscle mass can increase the risk of infection, decrease muscle strength & mass, increase the risk for comorbidities, increase the risk of death, and more. However, it would seem impossible to work out, move, and increase muscle mass with chronic fatigue, right? Well, not exactly. Strengthening, in many cases, is a primary key here.
How Strength Training Helps Fatigue
Fatigue stems from quite a few areas, as mentioned above. Still, for this article, we will talk about deconditioning as the source of fatigue, as deconditioning is a linchpin between all other conditions and fatigue. Your body can do a specific number of tasks each day, and your body needs the endurance to do all of those tasks. The strength of your muscles is a significant factor in fatigue. Your body needs to be strong enough cardiovascularly (heart and lungs) and musculoskeletally to provide your whole body the strength to get through a day with enough endurance not to run on empty and take energy from the next day by overdoing it.
Strength training works to combat fatigue by increasing your endurance. In this case, we are talking about muscle endurance, and although the science can get much more complex, it’s not necessary to understand how to combat it. You run around all day doing the same thing over and over, wondering why you become tired after a while. Becoming stronger, and working intentionally to strengthen the systems that are fatiguing helps improve your endurance. This is true for anything.
If you want to run a 5k race but can only run 1k right now, there’s no way you will run a 5k without training, right?
If you want to do a bicep curl with 15 pounds, but can only like 5 pounds right now, no amount of living your life the same way will help you get to that 15-pound mark.
This example can be said for anything, and it can be used to describe how strengthening your body will improve your ability to do your activities of daily living without extreme fatigue. You need to intentionally strengthen your system to be able to tolerate all of your activities.
Muscular strengthening programs, like Vestibular Group Fit, does this exactly. In this group, there is an opportunity for 6 days/week of workouts, which will strengthen your entire body. But cutting out 30-45 minutes of your day, a few times a week, you will be able to improve your overall endurance to be able to do more than you were previously. Your muscles will become stronger, your cardiovascular strength will improve, and you will be able to do more longer!
Energy Conservation for Fatigue
Energy conservation is planned rest and scheduled activity, which is helpful with chronic fatigue and chronic dizziness. Energy conservation is always helpful, with or without a fatigue dysfunction, but especially if you are becoming exhausted from activities that you used to not have any issue with. Energy conservation is the process of changing the environment or the task in order for it to match your energy levels and expenditure. Tactics like delegation, time management, task grouping, and interval rest are important to effective energy conservation.
Delegation
Asking for help where you need it is vital. People like to help, especially the people closest to us. Our loved ones are available to take on tasks when you don’t feel that you can. If you need extra groceries from the store, ask your partner to pick them up on the way home from work instead of making an extra trip out to get them. This helps conserve energy for when your whole family is home at the end of the day.
Time management
Manage your time in a scheduled way so you’re able to place high-energy tasks further apart from each other. When you have your day planned ahead of you, even if plans change, it will be easier to know what you can say yes and no to. If you’re having a day where you’ve managed to take a lot of time for yourself, and dinner plans pop up you will be able to say yes. It’s all about planning for what you need to do during the day, and not overdoing it into the next day.
Task Grouping
Grouping multiple tasks together that make sense together can be very helpful. Instead of making multiple trips out of the house daily, try making one trip for errands, but resting in between stores. You can take a break in your car or on a bench if you need, but you won’t have to drive both ways multiple times, saving you both time and energy.
Task simplification
As humans, we tend to overcomplicate things that should be simple. Try to buy precut vegetables, use grocery delivery services, sit to cook/clean/shower, and streamline your chores. The easier that all of these tasks are, the easier it will be for you to do more throughout the day! Really reflect on what you do day to day and try to implement simplification in at least 50% of them.
Interval Rest
Quit while you’re ahead. We tend to quit after we are running on empty and are feeling exhausted. In the photo below, the battery is slowly dying. Think of yourself like a battery that needs to be charged. Charging while you’re already partway charged is significantly more quickly than your phone’s battery dying and you needing to restart it. Rest before you absolutely need to charge. that means you may need a 15-minute nap or couch sit throughout the day. This is not something to be ashamed of; instead, be proud of yourself for listening to your body’s needs.
To decrease this fatigue overall, we need to strengthen your whole system. Taking time out of your day, every day, to schedule in simple strengthening exercises will build your battery so you will be able to be active longer without needing to stop due to fatigue.
Vestibular Group Fit has a Premium Content Module about fatigue. You will learn about prevention, energy conservation, treatment. And, the best part, is it can be completed from the comfort of your own home.
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The end of the year signals that we get to start getting excited to see all of our loved ones again! I know that since we have been stuck in a pandemic for SO long now, handling big events might need a little refresher. Holiday parties, cookie decorating get-togethers, and Thanksgiving day events are a lot to handle. This may be your first year managing the holidays with dizziness, or you may have years of experience. No matter where you are in your dizzy-journey, here are a few tips and tricks to help get you through the holiday season.
Check-in With Yourself
You know your body better than anyone. You determine where you go, what you do, who you see, and what you eat. If you want to go to a get-together with your friends, check in with yourself beforehand. How are you feeling? How long would you like to stay? Is there anything you need to do or bring to make your time there easier or more manageable? Setting ground rules and boundaries for yourself is incredibly important, and I absolutely recommend taking the time to reflect on your needs before you start getting together with others.
Bring Vestibular-Friendly-Foods
As a person with a vestibular disorder, it’s more than likely that you stick to some sort of diet. Even if it is not strict, you can never be too sure that there will be something you can eat where you are going. It’s really important to your vestibular system, especially with Vestibular Migraine or Meniere’s Disease, that your blood sugar stays constant, instead of having chronic fluctuations. Bring something you can keep in your bag to snack on, or bring a dish to the get-together you can share with everyone. That way, you can be sure there’s at least one thing you will be able to eat!
Stay Hydrated
Your brain is 75% water, and your vestibular system is largely water as well. Hydration is an absolute key to success when it comes to managing your vestibular disorder. If you are dehydrated, even without a vestibular disorder, you can become dizzy and feel off balance. So, if you do have a vestibular disorder it’s even more important to be sure you are getting enough water! Bring a water bottle with you and ask where you can fill it up. You won’t have to dirty a dish for your host, and you can be sure you’re getting enough to drink.
What to do About Alcohol
Avoiding alcohol with a vestibular disorder is frequently a given. However, you don’t have to avoid it 100% if your attacks are relatively under control. Some alcohols are more suitable for vestibular disorders than others, and I recommend giving it a try before you get to a party, but there are options for you! The alcohols that tend to be the least problematic are vodka, tequila, and dry white wine.
People who drink wine often have attacks due to the high levels of sulfites in the liquid. It’s almost impossible to find a wine with low enough levels for people with migraine and other inflammatory sensitivities, so PureWine has come up with a few solutions. These wine wands are easy to use. You just pop one in your glass of wine, wait a few minutes, and then you can drink. Be sure to follow the directions or you will not get the benefits. PureWine also has an option you can use as a pour spout as well to purify it upon pouring it from the bottle.
Photo from Newsweek https://www.newsweek.com/amplify/this-wine-wand-lets-you-enjoy-your-rose-without-hangover-heres-how
Be sure to drink AT LEAST 1 glass of water (8-10 oz)
for every drink you have.
Stick to a Schedule
Sticking to a schedule is of the utmost importance when you have a migraine brain or any sort of dizziness. During the holidays especially, because there are so many events, it’s even more important. Try your best to plan which events you have been invited to, how many you actually want to participate in, how long you want to go to said event, and how much energy it may take up. Imagine yourself as a cup. Before chronic illness, you may have been a pint glass, but with a chronic illness, you’re more like a small water glass. With a chronic illness, our cups empty more easily than before chronic illness and stay empty without adequate rest. Continue to strengthen your body regularly, sleep consistently, fuel your body appropriately with food and water, and rest when you feel like you need it.
Even if you’re a glass-half-full kind of person, it’s more difficult to physically fill that glass than it used to be. Manage your time, sleep, exercise, and events wisely this season for more successful holiday parties.
Decrease External Stimuli & Pack Accordingly
Holiday lights & music combined with excited, loud humans can make for an overstimulating environment. There are quite a few things to help this
- Migraine Shields: These glasses will help filter out the straining blue light that impacts your vestibular symptoms. They are made by a person with migraine, for migraineurs. I like them because they’re the lightest colored compared to other brands while filtering the blue light that affects you. This is different than wearing blue light glasses you get off of Amazon because it will only filter out the harmful blue light, rather than all of it. (code vertigodoc20 for 20% off your order!)
- Earplugs: If you’re going to a particularly loud event, where maybe there are will be significant echoing, a live band, or many people, consider packing earplugs. These ones are designed to decrease the amount of noise, without distorting the actual sounds. So you’ll be able to hear people around you speak, but it will be less stimulating and easier to listen to.
- Cane: A foldable cane, one that turns into a seat, or just a regular straight cane can help you to keep your balance inside a room where you may feel overstimulated.
- Hat: Any hat you feel comfortable wearing, especially during outside events or ones with strobe-like lights inside will help to decrease the amount of stimulus entering your system.
Set yourself a stopping point
Always try to decide where you’re going to stop before you start. If your goal is to bake holiday cookies, run errands, and get some work done in one day, that’s a great goal. But, if halfway through you’re feeling like you might be too exhausted to do so, quit while you’re ahead. It’s so much easier to fill your proverbial cup when it isn’t running on empty than it is to fill the cup if you’ve drained it and taken extra energy. I
Have you ever noticed yourself getting into this pattern? After a relaxing weekend, Monday comes around and you run errands like you are the queen of the world and can do anything. Then, on Tuesday you’re so exhausted you can barely get out of bed – so you rest. Then, on Wednesday you feel pretty good, so you get as much done as you can, and Thursday you’re so exhausted you can hardly make it to the bathroom or kitchen? This is a cycle that happens because there is not enough energy conservation going on. Expending all of your energy and then some on Monday makes it so you can’t do anything on Tuesday. This is not a good use of your time. Instead, try doing half of Monday’s activities on Monday and half of them on Tuesday. I would be willing to bet you’ll spend less time in bed, more time doing the things you love, and actually get more done throughout your week overall.
Following these tips will help you get to more events, decrease the amount of recovery you will need to make, and improve your overall quality of life. Never be afraid to excuse yourself from the party when you need to, and conserve your energy for later when you can!
Due to the complexity of migraine, and vestibular migraine, finding a treatment that works for you can seem impossible. However, with so much new migraine research, there is more evidence for new treatments constantly coming out. This is great, but can be hard to keep up with! One of the latest and greatest treatments for migraine are neuromodulation devices. That’s just a fancy word for electrical stimulation machines used to moderate headache and migraine attacks. The following devices can be either be used as treatments for preventative care, acute attacks, or both! Some have more research than others, and it’s not for everyone, however, anything that we can do to avoid migraine overuse headache and prevent migraine without pharmaceuticals is a win in my book!
Cefaly for Vestibular Migraine
Cefaly is by far the most popular new migraine-neuromodulation device I’ve seen recently. Patients love it, people all over Instagram love it, it gets all-around good reviews. I like it for a few reasons. The first is that they give a 90-day money-back guarantee. If you have migraine, you know by now that you need 90 days to determine if something work for you or not, and Cefaly provides that experience, because if it doesn’t work for you, you can send it back free of charge. Additionally, the first week is free, and it can be on a payment plan. Next, you don’t need a prescription. You can literally buy ti from Amazon and it will ship right to your door for a one-time charge. You do need to get new electrodes once in a while, but you can decrease the number you use by following the directions on the inside of the box to prepare your forehead correctly. The downside? there aren’t many, however, you will look like you belong in Star Trek or like you’re some sort of alien for an hour every day. It does prevent you from going out, unless you wear a big hat, or just don’t care that people might give you a funny look. Additionally, some people just don’t like the sensation, and therefore won’t use it.
The preventative mode is to be worn daily for 20 minutes, and an acute treatment is 60 minutes. You simply place it on your forehead, turn it on, and you’re good to go! You can even fall asleep with it on! In my opinion, it’s worth a shot!
eNeura: sTMS (Single-Pulse Transcutaneous Magnetic Stimulation) For Migraine
sTMS uses magnetic wave fields to pulse through your brain and soft tissue into your head to decrease the frequency of Migraine attacks. sTMS has been used for years, but the eNeura device is one of the first devices that can be used from home. You simply place it behind your head at the base of your neck and press a button to direct an impulse into your brain to prevent and treat migraine attacks. You will need to have a doctor prescribe it to you, so click here to find a doctor in your area who is familiar with the device and can see if it’s right for you.
Nerivio for Vestibular Migraine
Nerivio is used as a peripheral nerve stimulator in your arm to ‘confuse’ nerves in your brain to distract the pain from migraine. The message from your arm is sent to your brainstem and inhibits the pain signals from your brain stem that are causing the painful migraine. According to their research found on their homepage, 74% of people found it at least moderately helpful in relieving migraine pain. Additionally, it has an app that helps to track your migraine frequency and control the stimulation from your arm. You can wear it out, as it is on your arm instead of your forehead, and it will still be discrete. This one can be covered by your insurance, so if you’re looking for something that’s important to you, this may be a good fit!
GammaCore for Vestibular Migraine
GammaCore stimulates the Vagus nerve, which is the long nerve that wanders through your whole body. It affects your brain stem, heart, gastrointestinal tract, and more. GammaCore device is to be pressed against your neck, right next to where you can feel your pulse, for a specific duration of time. The biggest con to GammaCore is its price. The cost of GammaCore is about $200 every three months. This may seems expensive, however for some people it can reduce the number of other medications and hospital visits they may need to pay for. This would more than make up the difference. If it works for you it could absolutely be worth it! You do need a prescription to receive it, so ask your doctor!
Magnesium is an incredibly important supplement in our bodies, especially if we have migraine. Many studies have found that taking daily magnesium can help reduce migraine attack frequency and intensity. Typically the dose is 400-500mg/day for prevention, and then more for an acute dose if you’re trying to stave off an attack.
Types of Magnesium for Migraine
Magnesium Oxide
Magnesium oxide is the most common form of magnesium found in most stores, and if you pick up most drug store magnesium, it will likely be oxide. This is an affordable option and it’s in Class A of supplements, meaning it’s safe during pregnancy.
Magnesium Glycinate
Magnesium glycinate is the slightly less common form of magnesium, however its still easily accessible and does not cause the stomach upset that oxide does!
Magnesium Threonate
AKA CogniMag is something that many in the Vestibular Migraine community swear by for grain fog! IT’s a slightly different make up of magnesium and helps with improving cognition.
Magnesium in Foods
Many common foods are high in magnesium, and if you’d rather just try to eat enough throughout your day, you are welcome to try. The most common foods with high magnesium are beans/legumes, nuts and seeds, fiber-rich whole grains, dairy products, and many leafy greens. Although it’s entirely possible to get enough magnesium in your diet this way, it’s unlikely enough for a person with vestibular migraine, as a person with VM is typically low in magnesium, even if they eat a well-rounded diet.
Magnesium Spray
Magnesium spray is a topical form of magnesium that can help get magnesium into your bloodstream, without ingesting it orally. Because so many people are sensitive to magnesium in their gastrointestinal system, it’s not always an option to take it orally, even if you want to. A great place to start, other than your diet, are topical options! 4 sprays of this, on your skin, provides 66mg of magnesium! Although it’s a ways to get up to 400, it’s an excellent place to start!
Magnesium Lotion
Magnesium lotion, similarly to spray, is another topical option for you. This way, you won’t have gastrointestinal upset, but will still be able to increase the amount of magnesium your bloodstream absorbs. Additionally, it is a great way to practice self-massage on your neck. Take some of this cream, dab it on your neck, and rub your neck and shoulders for a neck-pain-relieving massage.
Magnesium Bath Soak
Sometimes when you are having a high pain migraine day, there’s nothing better than a warm bath. Pop this magnesium bath and foot soak in a bath of warm water and relax!
Magnesium Roller
The last option for non-oral magnesium is a roller. You can roll this anywhere on your body, it can sometimes help with sleep when put on your temples, or head pain relief!
Receiving a new diagnosis, one that you understand you have to live with forever, is jarring news; news that you likely never thought you were going to get. Accepting that you are now living with a chronic illness is not something easy to do.
As you probably know by now, I treat vestibular disorders but I do not have a vestibular disorder. However, I do want you to know that I write this post from a place of learning acceptance as well. Although I am not dizzy, I do have a chronic illness, Hashimoto’s Disease. It is a fairly common condition that affects your thyroid gland, and, similarly to Vestibular Migraine, affects 1-2% of the population annually. Learning to cope with a chronic illness is a process – it is not one that happens overnight, sometimes it can take years.
For instance, it can be really difficult to distinguish between life fatigue and fatigue that happens because of your diagnosis. It can be hard to learn your food triggers, because it may be something you’ve been eating your entire life and haven’t thought twice about it. And, largely, it can be hard to make a change when you’re so used to living with something that may have been left untreated for a long time. Accepting that you have a diagnosis is the first step in many senses, especially when it comes to living with a vestibular disorder.
Receiving an Accurate Vestibular Diagnosis
Vestibular specialists are hard to come by and when you finally find one, it’s likely that you have seen many other practitioners beforehand that have told you that you’re ‘totally normal’ or that ‘it’s all anxiety.’ The most common vestibular diagnoses are Benign Paroxysmal Positional Vertigo, Vestibular Neuritis, Vestibular Migraine, and Meniere’s Disease. There are many others, but they’re much less common.
Remember that vertigo is not a diagnosis, it’s a symptom. So, if you’re receiving the diagnosis of vertigo from your provider, either ask for another diagnosis or find a different provider.
When you receive a diagnosis, read up on it to make sure you fit the profile. For example, if you receive the diagnosis of BPPV, but your vertigo isn’t positional, try to seek another diagnosis. If your diagnosis does seem like you, congratulations on finding out the WHY of it all, even though it means you have to now deal with this new thing, it does not define you and it means you can start working to manage your symptoms.
Learning about your diagnosis
Every vestibular disorder is different. There are different symptoms, protocols, dietary needs, and lifestyle changes that are required for each one. Luckily, there has never been more research on vestibular disorders and their needs than there is right now. A great starting point for learning about your diagnosis is right here on this website. Under the “Dizziness” tab you can find the name of most vestibular diagnoses and definitions, treatments, and more. Before you make any changes, it’s best to learn what will actually help.
Because no two people are the same, it may be ineffective to ask others who have the same diagnosis and copy them exactly. Some people may be gluten sensitivity, while others are not. It’s important to keep in mind that your vestibular diagnosis is your own and that although others may be similar, no one else has the same treatment plan as you do.
How to Best Use Support Groups
Support groups can be the best and the worst tool at the same time. It’s vital to find community, relate to others, and ask for advice from others who know, and for that, I absolutely love a good support group. However, spending too much time in a support group, especially one where things may not be too positive, can be really frustrating. Know when you need to take a step back from the group if it feels like it’s becoming overwhelming or negatively affecting your psyche. You are more than your diagnosis, and although it’s important for you to have a community around you, it’s equally important that you are able to focus on non-vestibular aspects of your life.
Asking for Help (& Accepting It!)
You are not a burden on anyone. When you receive a diagnosis, your mind, body, and soul will go through many changes. You may not be able to do as much as you were able to, and accepting that new reality, having to do less throughout your day, and you may need to ask for help. As humans, we want to be as independent as well can, and do everything by ourselves – that starts when we are about 2 years old and never really stops. Asking for someone else to go out of their way to do you a favor, or to take on more than their normal load can be difficult. However, I’d like you to think of this backward.
If your best friend, neighbor, partner, child, or family member got sick or was going through something new and difficult, what would your initial thought be? Take a second and think about that.
I’m willing to bet the first thought that came to your mind was that you would want to help, right?
As much as we want to be independent, we also want to help. We are not as individual as we want to believe that we are. The “it takes a village” mentality is very real, and even when it’s hardest to admit, we do need help and people LOVE to help. If you find that by the end of the day you’re absolutely exhausted, you cannot manage to do anymore, but you still need to make dinner, ask for help then – but only the first time. I say this not because you shouldn’t ask for help making dinner, but because you should ask for help before you think you need the assistance.
We cannot give from an empty glass. You get one full glass a day, and prior to chronic illness, it’s likely that your cup was much bigger than it is now. Everything can take from your cup, doing laundry, walking the dog, getting your kids ready for school, brushing your teeth, eating, working out, and more. Every single thing you do takes energy. What things can you ask for help with? Can someone else walk the dog and make breakfast? Can you meal prep one meal so it makes it easier for you during the day?
Try making a list of all the little things you do throughout the day. Eating, cooking, laundry, dishes, and other small tasks – ask for help with those throughout the day so you’re able to make it to bedtime. Quit while you’re ahead, and your body will thank you for it later.
When you have a new diagnosis, managing the news, your new routine and your body’s needs might be enough to run your cup out of energy, however, there are ways to create a bigger cup, over time.
- Taking help, especially at first, with any task that seems daunting.
- Prioritizing movement – exercise can, over time, increase the size of your cup through strengthening and cardio.
- Find triggers for you – food, weather, stress, and hormones are big ones to be careful of
Remember, other people like to help. Good friends want to be there for you. Your partner can pick up some extra slack.
Setting Boundaries
It seems like the last few years everyone has really started to talk about boundaries, what they are, why they’re important, and how to ask for one. And, whoever these people are who created this term, are right – boundaries are really important. They’re important with family, romantic relationships, friendships, pets, and with yourself. A boundary is a limit that you set for yourself within a relationship. A person who has healthy boundaries is able to delve into intimate relationships and new experiences when they want to but also knows themselves well enough to set a limit for when they want to say no.
I want you to consider your own boundaries. Do you have them within your friendships or with family members? Do you have boundaries set when it comes to experiences, like you would never go skydiving? Are you able to open yourself up to others to ask for help when you need it? Do other people in your life have healthy boundaries? If you are sure you have healthy boundaries, that’s great! You are able to say no to a friend or family member if they ask you to go to a crowded gala where you are not comfortable, for example.
However, if you find yourself thinking that you may not have boundaries for yourself, try and think of a few that may help you. These do not have to be perfect or concrete the first time. These can fluctuate over time, and that is okay and normal. Start small, and try to be consistent. Boundaries can become habitual if they are repeated many times.
For more information on setting better boundaries, read this article.
Changing What You Can Control
When you ask for help and set a few boundaries, you have made an active change – that is excellent. You can only control yourself. Your actions, your emotions, your choices. It’s important to remember this because other people may be at the source of your symptoms, but you can choose who to be around, within reason. Choose yourself first.
If you notice that really big box stores are a trigger for your symptoms, you know you cannot control the fluorescent lighting and tall aisles. However, you can choose to wear a hat, Migraine Shields, and earplugs. You can also ask if someone else can go to the store for you, or use a store’s storefront pick-up or delivery options. Small changes in these actions will both use less of your cup and simultaneously relieve the stress of another errand that may make you increasingly symptomatic.
Focus on what you can do, instead of what you cannot control.
Although you cannot be in control of others, you can control you. If large crowded areas where people are darting across one another are problematic, avoid the mall during peak hours. Talk to your family about screaming and yelling in the house – little kids may seem like they don’t understand, but they do listen, and most of them want to be treated like an adult. Talk to them individually, or as a family, and share with them what’s going on with you, and why their parent needs a little extra help or quiet time sometimes.
Accepting What is Out of Your Control
Not everything is in your control, we learn this from a young age. As much as we may enjoy micromanaging and trying to get everyone on our page, it’s just impossible. There is always going to be crazy carpet at hotels and in airports, airplanes are going to his turbulence, and the car in front of you may unexpectedly slam on their breaks. All of these may be triggers for you. Remember to stay calm, and breathe through the moment. Moments like these are always going to happen, and stressing out about what might make you dizzy or otherwise symptomatic will bring on your symptoms more than the event itself. Being stressed out can cause dizziness, and increasing that anxiety can only make things worse.
Here are a few tips to help you get through moments of chaos
- Take a step outside. You do not need to be present in these moments, people understand that you may need to leave. And if you do not feel comfortable explaining, excuse yourself to the restroom.
- Practice grounding standing up. Root your feet into the floor, breathe in through your nose, hold, breathe out, hold. Each should be for 4 seconds, for a total of 16 seconds per breath.
- Block time on your work calendar throughout the day, 15-30 minutes, to take time for yourself if needed.
- Take a walk alone, or with a friend, to clear your head.
Vestibular Migraine, as I’m sure you know by now, can be incredibly challenging to manage. Between weather changes, hormone changes, food triggers, and decreasing your caffeine intake, ‘a challenge’ doesn’t even begin to describe it. There’s a new study that I wanted to bring your attention towards, Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial.
This article is interesting because instead of taking another thing out of your diet, it talks about something you can and should eat more of – finally!
What Food Group is Great for Vestibular Migraine?
This new study from the British Medical Journal shows that increasing Omega-3 Fatty acids, and without decreasing Omega-6’s can help decrease migraine pain, days, attacks, and other migraine-related symptoms.
The research shows that altering Omega-63s without changing Omega-6’s can decrease pain severity and frequency of attacks. However, the research did not find that there was a significant difference in quality of life.
What’s the Science between Omega-3’s and (Vestibular) Migraine?
Vestibular Migraine occurs due to a complex cascade of events that begins in the brain stem and trigeminal nerve, impacts the trigeminocervical complex, and then impacts the vestibular system. This cascade of events is what causes both pain (trigeminal nerve) and dizziness (vestibular nerve) in those with vestibular migraine. Omega-3’s are protective against that response.
As human beings, we are great at many things, however, synthesizing our own Omega-3 and 6’s is not one of them. Therefore, we can alter the number of fatty acids we have at any given time with our diet and/or supplements. And, it just so happens that these fatty acids are essential to the migraine cascade – in fact, they have a big role in pain regulation.
The nerve endings of the trigeminal nerve (the one that causes pain in migraine) are regulated by these same fatty acids, called lipid mediators. These mediators and together known as oxylipin receptors, and they’re enriched at the end of the trigeminal nerves. They regular sensitization and the release of the headache-related neuropeptide calcitonin gene-related peptide (1). This fact implies that there is a link between omega-6 & 3 fatty acids and headache etiology.
The oxylipins that come from Omega-6’s have been found to “sensitize the trigeminal nerve endings, and evoke behavioral pain responses;” this means Omega-6’s can increase pain severity and migraine frequency (1). However, the oxylipins that are derived from Omega-3’s are found to have antinociceptive properties, meaning that they reduce pain (1).
Where do I Find Omega-6’s, and Should they be Avoided?
Omega-6, the kind of fatty acid that is found mostly in the typical American diet, in fact, there is research to show that most people who eat a Western diet eat significantly more Omega-6s than Omega-3’s. Omega-6’s do play a role in our body’s function, so you should not completely get rid of this kind of fat. However, because we eat so much Omega-6, and want to try to fit in more Omega-3, it’s important to know where they come from.
- Vegetable oils
- Soybeans
- Corn/corn oil
- Eggs
- Some meat and fish
Where Do I Find Omega-3’s?
Omega 3’s are to kind of fatty acids we don’t get enough of in the Standard American Diet. It’si’mportant we get more of these than Omega-6’s so we can desensitize the trigeminal nerve, decrease pain severity, and decrease pain days overall. Although it may be easier for you to take them as a supplement, it is better to get them in your food, and more affordable. However, if you do not like any of these foods, it is typically recommended to get them in supplement form (aka Fish oil). Ask your doctor before you change or start a new supplement.
- Salmon, mackerel, or other fatty fish
- Seaweed and algae
- Chia and hemp seeds
- Walnuts
- Edamame
- Oysters & shrimp
- Spinach & Brussels
- Supplements
Source:
Ramsden, C. E., Zamora, D., Faurot, K. R., MacIntosh, B., Horowitz, M., Keyes, G. S., Yuan, Z.-X., Miller, V., Lynch, C., Honvoh, G., Park, J., Levy, R., Domenichiello, A. F., Johnston, A., Majchrzak-Hong, S., Hibbeln, J. R., Barrow, D. A., Loewke, J., Davis, J. M., … Mann, J. D. (2021, July 1). Dietary alteration of N-3 and N-6 fatty acids for headache reduction in adults with migraine: Randomized controlled trial. The BMJ. Retrieved October 5, 2021, from https://www.bmj.com/content/374/bmj.n1448.
Your journey with Migraine is complex, changing, and can be confusing. There are so many things you can try, many of which I may not have even heard of – it truly take a well rounded healthcare team to treat Migraine, and in this case, Vestibular Migraine. Exercise, even for just 30-40 minutes, can help prevent and treat Migraine attacks. It is difficult because in the moment exercise may sound like the most impossible thing to do with your body. But, if you start slowly, even during a Migraine Attack, you can help cut down the time or prevent the attack entirely.
Why Exercise?
We all know, tucked away somewhere in the back of our brains, that exercise is good for us. It has many health benefits from stress relief to heart health. National College of Sports Medicine recommends 150 minutes of moderate intensity exercise/week, which can be broken up into smaller sections of your choice, to meet that guideline. This guideline, combined with the Migraine-prophylaxis guideline, is a great place to start for overall health and wellbeing.
Migraine attacks can be prevented with light, moderate, or high intensity exercise. Any form of exercise that you enjoy counts – yes, even walking, barre, and Pilates count! The best part about exercise, is that just about any form of movement is helpful.
Exercise is so effective in preventing migraine, that this study from 2011 found that exercise, regular meditation/relaxation, and topiramate were equally effective in stopping a migraine attack. In this study, those who were in the exercise group were to exercise with a physical therapist for 40 minutes, three times a week. This exercise program had a 15 minute warm-up, 20 minute workout time, and 5 minute cool down. There were absolutely no adverse effects in the exercise group, however the topiramate group had 8 participants with adverse effects – just another reason to utilize exercise as a treatment and preventative!
Exercise can also help your symptoms to improve more quickly during Vestibular Rehabilitation Therapy. If you have Vestibular Migraine, Vestibular Rehabilitation Therapy is hopefully a part of your plan for recovery! Vestibular Rehabilitation Therapy is the exercise program used to habituate, or teach, your brain how to respond to irritating stimuli. This process is most effective when patients and clients are encouraged to exercise as a piece of their rehabilitation.
Where Do I Begin?
Beginning to exercise again can be a difficult step – that’s why we created Vestibular Fit! Vestibular Fit is the custom exercise program built for those with vestibular disorders. Returning to exercise after diagnosis, treatment, and management of a vestibular disorder can feel daunting. Sign up for Vestibular Fit and we will get your workouts customized to you in the next 48 hours!
There are few things as good for your body, and soul, as physical activity. the best kind of exercise is the kind that you will do. I mean that – if you like to jog, let’s make that happen. If you love to go to Barre, let’s get you back to class!
Sources:
(1 )Amin FM, Aristeidou S, Baraldi C, et al. The association between migraine and physical exercise. J Headache Pain. 2018;19(1):83. Published 2018 Sep 10. doi:10.1186/s10194-018-0902-y
(2) Penney, S. (n.d.). Fitness. how much activity is enough? NASM. https://blog.nasm.org/fitness/fitness-how-much-activity-is-enough.
Vestibular Rehabilitation Therapy is the process of improving your imbalance, dizziness, vertigo, and other vestibular symptoms through exercise. To read more about the process of Vestibular Rehabilitation Therapy and how it works, click here.
How to Test Your Vestibular System
Your vestibular system can be tested in multiple ways, but there are a few tests and measures that I use most frequently in the clinic. These are the four most common tests that I find make people mildly symptomatic, and provide solid objective measurers that I can treat through Vestibular Rehabilitation Therapy.
The first measure I use is the Dizziness Handicap Inventory. This is a standardized scale that consists of 24 questions regarding your functional, physical, and emotional limitations surrounding dizziness and vertigo. It provides me as a Vestibular Physical Therapist an objective way to measure and track patient progress.
Next, I screen all of my patients’ ocular motor skills. I test visual tracking, visual range of motion, end range nystagmus, convergence, saccades, and for spontaneous nystagmus with and without fixation.
The Vestibular Function testing comes last in this order, as I need to be sure I check for central dysfunction before peripheral vestibular dysfunction. The next tests can check laterality of a vestibular lesion in some situation, gaze instability and use of Vestibulo-ocoular reflex, and your ability to cancel our your Vestibulo-ocular reflex.
1: Head Thrust Test (Head Impulse Test): this test can tell laterality of a vestibular lesion, usually after a Vestibular Neuritis, if the loss is 40% or more on one side. Ask the patient to stare at your nose, and quickly move your patient’s head left and right. If their gaze slips off their nose and you see a catch up saccade, that is the side of the vestibular lesion.
2: Dynamic Visual Acuity (DVA) Test: this test screens for gaze instability. You should start by reading an eye chart, the lowest line you can read comfortably. Next, your Vestibular Physical Therapist will shake your head right and left at 240 BPM in approximately a 60 degree motion. While your head is moving, you should read the chart again. This is scored by the number of lines between your static and dynamic head positions. A difference of three or more is clinically significant for gaze instability.
3: Vestibulo-ocular Cancellation (VORcX): this is a test for visual motion sensitivity via the cerebellum’s ability to inhibit the Vestibulo-ocular reflex. Standing, clasp your hands in front of you and place your thumbs up and together. Stare at your thumbs and swing your whole body and hands right and left, keeping your eyes on your thumbs the whole time. Repeat 10 times .While you are performing this motion, your PT should watch your eyes for saccadic eye movement, which indicates a positive test. Additionally, a positive test is if this makes you symptomatic.
4: Dix-Hallpike & Horizontal Roll Testing: these tests are for Posterior and Horizontal Canal BPPV. I only test for BPPV when my patients have a subjective history of rotary vertigo with position changes, or have other risk factors that make me curious. Because it’s easy to treat, and a quick test, I find it is usually worth my time to test most patients.
Best Vestibular Rehabilitation Therapy Exercises
The best Vestibular Rehabilitation Exercises will make you slightly dizzy, but not so dizzy that you feel faint, dizzy, or ill the rest of the day. Your symptoms should last a few seconds to minutes, and you should then be able to bring those symptoms back down to your baseline level.
Prescribing exercises for Vestibular Rehabilitation Therapy completely depends on what makes you dizzy. Your Vestibular Physical Therapist should perform a few objective measures, and also consider the subjective actions that make you dizzy.
Positive DVA Testing tells me as the clinician that you should begin VORx1 exercises (Vestibulo-ocular Reflex Times One). This will help with gaze stability. Other cues you may need VORx1 are: you have difficulty keeping your eyes focused in one place, you have the sensation that things “bounce” when you’re walking, or that you feel like you have a “lag” when you move your head.
- Stare at the pineapple in the center of the chart, and shake your head horizontally (the “no” direction) in a quick, small movement
- Perform this movement for 15 seconds as quickly as you can without allowing the pineapple to go out of focus or jump around.
- Stop, let your symptoms dissipate. Before repeating, your symptoms should return to your baseline (the level of dizziness you had prior to beginning this exercise).
- Repeat 3 times, resting completely back to baseline in between each set.
A positive VOR Cancellation Test means you should practice VOR Cancellation (VORcX) and/or being other visually stimulating environments. You can do this by performing VORcX as an exercise until you’re symptomatic and then performing grounding in between sets, or to simulate a stimulating environment you can walk into a busy environment, or watch something on a screen.
VOR Cancellation Instructions:
- Standing, clasp your hands in front of you and place your thumbs up and together.
- Stare at your thumbs and swing your whole body and hands right and left, keeping your eyes on your thumbs the whole time.
- Repeat until you are mildly-moderately symptomatic.
The Importance of Your Baseline
In between each repetition of a vestibular exercise, you need to return back to your baseline.
When your brain is already dizzy, and you’re performing an exercise to make yourself (briefly) dizzier, your fight or flight system is stimulated. We need to remind your brain that you are in a safe environment, that you can feel relaxed and calm in the face of dizziness. Because our brains are ‘plastic’, meaning we can teach ourselves anything, we can teach our brains to be stronger against dizzying stimuli.
Grounding is the answer to this in many ways. Grounding is the act is the act of feeling your stillness. Feeling your feel on the floor, your back in the chair, your arms on the armrests, and so on. Then, sit and breathe slowly, completely, and deeply. Be mindful of your surrounding and your stillness. This is a practice that can be meditative.
Return back down to your baseline dizziness level between each repetition. This is actually the most important part of vestibular exercises. Before restarting your exercises you should be absolutely sure that you’re feeling back to where you started!
Here’s a good rule of thumb for Vestibular Rehabilitation Therapy: no more than 5/10 symptoms over baseline, and for no more than 5 minutes at a time.
How to Dose Vestibular Exercises
Vestibular Exercises should be scaled, graded, and dosed based on your exact needs. Your Vestibular Physical Therapist should perform a test or provocative movement, and then see if you become symptomatic.
If you are symptomatic, stop, perform grounding, and then begin again when you’re feeling ready.
For VORx1 Exercises, I typically ask my patients to perform them 3 times a day for 15 seconds at a time. These can be all back to back 15s, grounding, 15s, grounding, 15s. Or, you can do one set each at breakfast, lunch, and dinner.
This is a good rule of thumb however no everyone can tolerate 15s, so if that is the case, I find a number my patient can tolerate and work up from there.
The same thing goes for all vestibular exercises. Find a level of movement that is difficult but tolerable, perform grounding, and then begin again.
Migraine and Vestibular Migraine can be reduced and managed naturally with vitamins, minerals, diet, and exercise! People often ask me which vitamin deficiencies cause migraine and if you should be tested. Although your doctor can test you, that’s not a requirement as most people with migraine do have issues with these deficiencies in most research. These vitamins include Magnesium, CoQ10, D3, Riiboflavin (B2), and Omegas!
Natural migraine treatments can be paired with your medical treatment, however, be sure you tell your doctor what you’re taking as some vitamins for migraine can have an impact on your prescription medication – there are always options, so its best to be safe!. Some people use natural migraine treatment alone, without the need for Here’s a list of vitamins and other accessible over-the-counter treatments you can try. As always, ask your doctor before you change or add anything to your treatment plan!
The most common supplements for Vestibular Migraineurs are CoQ10, Magnesium, and Riboflavin (B2). Some supplements, like Migralief have all 3 combined, which makes remembering to take it easier. However, sometimes just because it’s easier doesn’t mean it’s better – some of my patients have been very successful with taking Migralief, but others have needed to take each one separately for multiple reasons.
Magnesium for Migraine
Magnesium has so many purposes in our bodies. It helps with mental clarity, digestion, nerve function, blood sugar, and more! Taking keeping magnesium available in your body for use is called bioavailability. Different kinds of magnesium supplements help with different difficulties you may have related to migraine
Magnesium Glycinate
Magnesium glycinate is used for mental clarity and digestive health, without causing digestive issues or a crash at the end of the day. Glycinate is an amino acid that your body uses to fight inflammation and improve sleep. Magnesium glycinate also occurs in foods such as meat, dairy, and legumes. Since those on a Migraine Diet or Heal Your Headache diet may be avoiding most dairy and some legumes, glycinate may be lacking in your diet. It’s important we have all the necessary amino acids in our diets, so a magnesium glycinate supplement may be a great idea for you!
Magnesium Threonate
Magnesium L-Threonate is when we combine threonic acid and magnesium. This form of magnesium is a formed to be easily digestible and is great for mental clarity. Studies have shown that it helped promote learning and memory, and helped prevent memory decline. Threonate is already present in some level in our cerebrospinal fluid, and the presence of extra in neuronal cultures “increased functional synapse density” (2). Really good Magnesium Threonate, like the kind form Pure Encapsulations, is really hard to come by. If you can’t find it from Pure Encapsulations on Amazon, they have another show online here.
Magnesium Citrate
Magnesium Citrate is often used for treating digestive issues, such as constipation. Magnesium citrate is the most available form of magnesium – this is the kind of magnesium that you find generically in stores. This form of magnesium is also commonly found in powder form. If you have trouble with the bathroom in general and are a person who deals with chronic constipation it might be good to take Magnesium Citrate. However, if you do not, be more cautious about this – you might spend a little extra time in the bathroom than you had intended if you take Magnesium Citrate.
For more into on forms of migraine, you can take, click here!
Coenzyme Q10
Coenzyme Q10, or CoQ10, for migraine is used for preventing oxidative change in your brain. Migraine Brains hate change – so preventing large changes in oxidative stressors within your brain will help decrease the number of migraines in your life. CoQ10 helps support mitochondria by creating adenosine triphosphate, which helps us with energy (3, 4). Some studies have shown that CoQ10 can help with episodic migraine prevention up to 15 episodes per month. CoQ10 is made by Pure Encapsulations, like Magnesium, in pill form which is of high quality. It is also in chewable gummies made by NOW Supplements which patients have reported is effective as well.
Riboflavin (B2)
Riboflavin, which is a form of B2 vitamin, is effective in preventing migraine (5). Migraineurs are frequently B2 deficient, so supplementing your body this vitamin can be incredibly helpful in migraine prevention. Riboflavin is generally well tolerated, affordable, and will likely make you feel better. In the study, of people who took Riboflavin for the 3 month trial, 59% reported decrease in migraine symptoms by at least 50%. Riboflavin is useful in brain function, skin cell production, gut/digestive lining, and more. People who have migraine are typically deficient in B2, so it’s a good idea to supplement it into your diet. B2 can be found in eggs, milk, meat, nuts, enriched flour, and more If you do not tolerate these foods well, especially if you’re on a strict migraine diet, it could be a good idea to supplement it in vitamin form instead of trying to eat enough throughout your day. The typical dose is 400mg/day for at least 3 months, but as always, ask your doctor for more information!
It is significant, however, that riboflavin has been shown to interact with some medications like antidepressants and some cancer drugs, so be sure to check with your doctor first!
Omega-3 For Vestibular Migraine
A new study found that having more omega-3’s than omega-6’s is helpful for preventing pain and migraine frequency/days. We have two main forms of Omega-fatty-acids in our bodies. The first is Omega-6 and the second is Omega-3. Omega-3 has long been known to be healthier and better to have more of in your body. You can find it in avocados, fatty fish, and other nutrient-rich foods. Its other form is Omega-6, and is known not to be as healthy. This study found that increasing the number of Omega-3’s a person had, without doing any alteration of Omega-6, decreased headache frequency. Both Omege-3 and -6 are not synthesized internally, meaning that we have to eat them to get them in our bodies, or we have to supplement them or eat them!
Melatonin for Vestibular Migraine
New research shows that melatonin could be very helpful in treating vestibular dysfunction. MT1 receptors interact with melatonin, and are found all over the same parts of the brain that the vestibular system is! This study says “melatonin has been proposed as a prophylactic agent in the prevention of migraine attacks, a condition that can be associated with vertigo” (8). This study also states that in animal models melatonin has been found that it can be otoprotective (protective for the ear). 3mg was taken daily during this study, and it should be taken at night before you go to bed. This way you can not feel extra sleepy during the day.
Vitamin D3 for Vestibular Migraine
Vitamin D3 can be helpful in preventing vestibular migraine, but the mechanism is not clear. There is not a lot of evidence to recommend it to all patients with migraine or vestibular migraine, but it’s great to ask your doctor if it’s a good fit for you. Many people are vitamin D3 deficient, especially with migraine. There is some evidence to show that there is a decrease in migraine frequency and pain when vitamin D3 is supplemented. This is especially important when it is not sunny outside, or if you live in a particularly foggy place! We get D3 via UV waves, but if we don’t live in a sunny place, or you live in a house/apartment without a lot of light, it’s important to find a way to get it in. Supplementation is frequently the answer here!
Sources:
(1) https://www.healthline.com/nutrition/magnesium-types
(2) https://pubmed.ncbi.nlm.nih.gov/27178134/
(3) https://www.verywellhealth.com/coenzyme-q10-migraine-prevention-1719853
(4) https://www.migrainetrust.org/living-with-migraine/treatments/supplements-and-herbs/
(5) Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology. 1998 Feb;50(2):466-70. doi: 10.1212/wnl.50.2.466. PMID: 9484373
(6)Wolff, A. (2020, April 5). The Best Magnesium Supplements for Migraine. The Dizzy Cook. https://thedizzycook.com/magnesium-supplements-explained-which-one-is-best-for-vestibular-migraine/