Chronic Headache & Migraine

Migraine affects approximately 39 million Americans and is among the most disabling neurologic conditions worldwide. Chronic migraine (≥15 headache days/month) carries enormous burden on quality of life, productivity, and mental health. Standard care focuses on acute abortive medications (triptans, NSAIDs) and prophylactic pharmaceuticals (topiramate, propranolol, amitriptyline, CGRP antagonists) — without systematic investigation of the physiologic triggers and nutritional deficiencies that drive migraine susceptibility. Known modifiable drivers include magnesium deficiency (present in up to 50% of migraine sufferers), riboflavin (B2) deficiency, CoQ10 insufficiency, mitochondrial dysfunction, sleep disruption, hormonal fluctuation, dietary triggers (tyramine, nitrates, MSG, alcohol), and cervicogenic dysfunction.