What Actually Causes Chronic Migraine? A Mechanistic Reading of Treatment-Resistant Migraine — Frequently asked questions about chronic and treatment-resistant migraine

Why don't CGRP antibodies work for me? The most common reason is that the dominant driver in the case is not predominantly CGRP-mediated. CGRP antibodies act downstream of all four drivers and work best when the case is dominantly mediated through the CGRP-dependent component. Can I come off my preventive medications? That decision is between you and your neurologist. The framework is not a strategy for stopping prescription medication. What about vestibular migraine? Vestibular migraine sits in the same framework. Driver 1 (mitochondrial) is often particularly dominant because the vestibular system is bioenergetically expensive. Driver 3 (gut-brain) is also frequently dominant. Why does my migraine get worse in perimenopause? This is Driver 4 becoming dominant. The hormonal stability that buffered the underlying drivers in younger years is lost. Should I try riboflavin and CoQ10? The evidence base is reasonable. Riboflavin at 400 mg daily, CoQ10 ubiquinol at 200-400 mg daily, and magnesium glycinate at 400-600 mg daily are reasonable additions to most preventive regimens. Is Mohammed Attallah a doctor? No. Mohammed Attallah is an independent systems-biology researcher and developer of the Host Capacity Model. He is not a licensed clinician. What does a Biomelogic migraine consultation cost? The Standard Consultation is $650 one time, which includes the case review, the live se