I’m a neurologist and this is why the McDonald’s hack for a migraine works a trick

WHEN a migraine hits, most of us make a beeline for a dark room and hope the painkillers kick in fast.
But what if popping into a Maccies could help stave off your throbbing headache?
According to neurologist Dr Jessica Lowe, a large Coke and chips could "miraculously make your migraine go away" due to a few key ingredients.
Know as the "McDonald's migraine hack", the US-based specialist said the trick "is relatively well known" to people who frequently suffer from migraines.
In a now viral video posted to TikTok and Instagram, Dr Lowe - who suffers from migraine attacks herself - broke down just why the hack might work for some people.
"I'm a neurologist with migraines. Ain't that ironic?" she said in the clip.
"The order is a large Coke and a large order of fries. And this somehow miraculously makes your migraine go away.
"This can be easily explained."
The hack's efficacy comes down to caffeine, salt and carbs, the neurologist said.
"So, first of all, a large Coke from McDonald's has about 80 milligrams of caffeine in it."
That amount of caffeine alone "is probably enough to stop your migraine in its tracks", Dr Lowe claimed.
According to The Migraine Trust, caffeine may help stop a migraine attack for some people, while for others it may trigger it - so whether or not a large Cola eases your headache will very much depend on the person.
"Also, McDonald's is well known to have some of the saltiest fries around," Dr Lowe went on.
"Salts, electrolytes. Easy."
Some people may find that electrolytes - such as sodium, potassium, and magnesium - can help ease migraines, as dehydration can trigger the headache.
"And then of course, fries or carbs," Dr Low said.
A migraine usually feels like a very bad headache with a throbbing pain on one side.
You may get other symptoms just before a migraine, such as:
- Feeling very tired and yawning a lot
- Craving certain foods or feeling thirsty
- Changes in your mood
- A stiff neck
- Peeing more
You may also get warning signs you're about to have a migraine - called an aura - such as:
- Problems with your sight, such as seeing zigzag lines or flashing lights
- Numbness or a tingling that feels like pins and needles
- Feeling dizzy
- Difficulty speaking
Source: NHS
"A lot of people have migraines that are provoked by hunger or just their glucose starting to drop, so those carbs are certainly gonna help out in that department."
However, the doctor did point out that the McDonald's migraine hack may not be the healthiest road to go down - it is fast food, after all, and you'd do well not to resort to it too often.
She said: "Are there healthier ways to accomplish this? Yes.
"Fun fact one tablet of Excedrin has I think 60 to 65 milligrams of caffeine in it.
"The dose is typically two, so that'll put you between 120 and 130 milligrams of caffeine.
"That's an easy way to get the caffeine components of this cocktail."
Excedrin is an over-the-counter headache pain reliever. Anadin or Soldadeine are UK equivalents that contain caffeine.
If you're after a dose of electrolytes, Dr Lowe advised you "chug a Gatorade" instead of a fizzy drink.
"This will likely also help with hydration in addition to the electrolytes," she added.
"So two birds, one stone.
As for a dose of carbs, the neurologist said: "It's probably not difficult to find a carbohydrate that is healthier than deep fried potatoes, so go for gold.
"But with that being said, you know, we are all human, and when you are feeling unwell, sometimes you just want some comfort food.
"I get it. Not knocking the hack, just don't make a habit of it."
Often the only way to get rid of a migraine is to take painkillers and sleep it off.
Sufferers normally rest up in a dark room until it has passed - which can be up to 72 hours.
There are many options for migraine that can be tried - some help at the point of migraine and others are preventative.
And there are new treatments coming onto the market that are not just repurposed drugs for other conditions.
Triptans
Triptans reduce the pain and sickness of a migraine attack at the time they are taken.
Naratriptan and frovatriptan usually take longer to reach their maximum effect but their effect lasts longer.
But if a patient's attacks peak quite quickly, a triptan such as sumatriptan, zolmitriptan, eletriptan or rizatriptan may be more appropriate.
Two doses of any triptan are allowed in 24 hours and they should not be used more than 10 days in a month.
Analgesics
This is medication that treats the pain of a migraine attack at the time they are taken and includes paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Prophylactics
Prophylactics are preventative medicines for migraines taken every day.
Most preventive medications currently available are repurposed from other conditions.
They include:
- Angiotensin II blockers (for hypertension)
- Anti-convulsants (for epilepsy)
- Anti-serotonergic drugs (for depression)
- Beta-blockers (for hypertension)
- Calcium channel blockers
- Tricyclic antidepressants
- CGRP monoclonal antibodies (described below)
Botox injections
Botox (botulinum toxin type A) is a type of nerve toxin that paralyses muscles. It was discovered that those who had the cosmetic injections had fewer headaches.
Botox is approved for use on the NHS for the treatment of chronic migraine - at least 15 headache days a month - in adults who have tried other treatments.
Doctors think it works by blocking chemicals called neurotransmitters that carry pain signals from within your brain.
CGRP monoclonal antibodies
Calcitonin gene-related peptide antibodies (CGRP) monoclonal antibodies (mAbs) are a new type of treatment for migraine.
CGRP mAbs are the first preventive medicines specifically developed for the treatment of migraine.
Several are now available on the NHS. This includes erenumab (brand name Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality) and eptinezumab (Vyepti).
The drugs target CGRP, released by the nerves and blood vessels during a migraine attack. It is thought to cause pain.
The new drugs target CGRP to prevent migraine developing.
All of the medicines are taken by injection, either monthly or every few months.
Gepants
Gepants are like the tablet form of the injectable CGRPs antibodies described above.
There are currently three gepants – ubrogepant (not yet on the NHS), atogepant and rimegepant - and others in development. They are CGRP receptor antagonists.
Gepants bind to the CGRP receptors on nerves and block its effects. Gepants (unlike triptans) do not constrict or tighten the blood vessel. They prevent them from dilating.
This makes them safer for people with heart issues and they can be used in people with cardiovascular disease.
Early indications suggests that gepants may be the first acute treatment not associated with medication overuse headache. Due to this, they may also be used as a preventive treatment.
Greater Occipital Nerve (GON) block
There are injections which contain small doses of local anaesthetic and/or steroid which is injected around the greater occipital nerve - which travels up each side of the back of the head.
Evidence suggests a GON block can provide short-term benefit to some people with migraine, reducing how often migraines occur and their severity.
Around one in three people do not see any benefit from a GON block.
Lifestyle measures
If none of these treatments help a patient's symptoms, or they're getting worse, a referral to a specialist may be made.
A GP may also recommend making changes to lifestyle to help manage migraines, such as eating at regular times and drinking less caffeine.
These include:
- Eat meals at regular times
- Exercise
- Get plenty of sleep
- Manage stress
- Drink plenty of water and less alcohol and caffeine
- Limit trigger foods, such as spicy food
Sources: NHS and The Migraine Trust
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