In the days before I talked about lifestyle so much with my patients, I treated migraine according to the standard way as outlined by our local neurologist at the tertiary centre, but I tended to gloss over the first section about addressing lifestyle.
Nowadays with my focus on diet and lifestyle, I look at that carefully first. For instance, there is not much point looking at triptans, if a person’s nutrition consists of just biscuits.
Today I saw a 50 yr woman who had what I call a busy person’s diet:
Cereal bar or toast at work.
Sandwich for lunch
Pasta for tea
Fruit as snacks
The trouble with this way of eating is that the blood sugar will be up and down all day in a random way, and as a result she will be very carbohydrate dependent and probably have to have a snack every 2-3 hours.
There are doctors who suggest that a real food way of life( higher in good fats and lower in sugars and starches) does away with the need to eat a meal or snack every few hours, and that eating like that will tend to make headaches go away. It is worth discussing and is what I suggest before any other methods- such as drugs- are tried.