Just Give Me A Lab Test...

Just give me a lab test - a blood test - a scan - tell me what's wrong and how to fix it!

In our May issue of HeadWay, we talked briefly about some of the reasons why typical scans are of little use in migraine treatment. And yet cutting edge research is always looking for the simple test that will classify your headache and lead to the perfect customized treatment.

For example, a study published in March in the journal Cephalalgia found two different groups of migraine patients based on structural and functional MRI. One group tended to be older and have more disabling attacks.

But once again, the situation is complex and a long way from getting a customized treatment from a scan. How can we prove that this is a "type" of migraine that will likely benefit from certain treatments? (At this point, we would use trial and error... - but also an understanding of your symptoms...) If this shows two biologically different types of migraine, would they even require two different types of treatment?

But - this is still an important study!

Before continuing, let me say that I support these types of studies. They are a step in the right direction - to understand migraine better, and thus to find better treatments for the individual.

One of the researchers is the well-known Dr. Robert Cowan. A recent article about the study from the Stanford Medicine News Center mentioned that Cowan's team wants to go on to investigate "blood biomarkers". Once again, the hope is to give you a blood test, and then give you the medication most likely to help.

What to do instead of that test...

These studies are nothing new. We've been talking about blood tests for years, as well as scans such as MRIs. But the reality today is still that going to a headache specialist who knows your medical history will be far more useful than a blood test or a head scan.

That being said, depending on your symptoms, there are times when a scan or blood test are wise. Not because they will tell you something about migraine, but because they will rule out other conditions that may require quite different treatments.

I was talking with a friend a few weeks ago whose doctor had recommended a scan for headache. But as we talked, I got the feeling that the doctor was prescribing the scan more to make the patient feel like "something was being done", and not because there was any scientific and medical reason to do it.

Do ask your doctor "Why?". If the answer is because certain symptoms indicate such and such a disease that a scan will help you diagnose, great. If the answer is "just to cover all the bases" or "it wouldn't hurt" - just skip it.

Conclusion

The end of the story at this time in history is this. We still understand very little about migraine and headaches and the brain. It's not likely that a blood test or a scan will lead you to better treatment, although it will take time and money. However, talking to a headache specialist with experience who knows your medical history and other conditions you may have is much more likely to get you on the right track.

Even so, you may have to try several things to get the best treatment for you. Be patient.

One more note. There is a push today to recommend preventative treatment to patients who do not have chronic migraine. One does have to be suspicious of any push designed to sell us more drugs. However, sometimes the narrow classification of chronic or episodic isn't enough - someone with episodic migraine (less than 15 attacks a month) may be highly disabled. They may indeed benefit from a preventative medication. Don't rule it out.

But don't expect to go to a lab and get numbers from a computer which will tell you exactly the treatment that will work. We're not there yet.

But we've come a long way, and there are many excellent medicines, treatments, and lifestyle adjustments that might mean a major improvement in your life. Take a step today - your future self will thank you!

Thanks for reading! Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom. Your password is nomoache.

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