It is hard keeping up with 2+ hours of headache content a night, so I've been posting notes on the main ones that seem applicable to CH.

Can A Ketogenic Diet Prevent Migraine? - Worth a watch with the interviewee working on his doctorate in this area.

Skipping meals isn't a great idea, especially if you snack on carbs as you get a sugar spike which then drops off as rapidly as it rises.

Food triggers are complex, with not all people being impacted by all the common triggers, even down to even if a food can be a trigger then it isn't always, plus if you've been headache free for a reasonable time then it might stop being a trigger. Most people tend to only have a few triggers, often 4 or less.

Some food triggers might appear to be a trigger, but it could be the symptoms kicking the food craving. Their example was the migraine pro-drome phase makes them crave chocolate so chocolate isn't the trigger, the migraine is triggering chocolate.

The keto diet reduces CGRP, which is possibly how it is impacting headaches.

There is good evidence for it in some areas including obesity, epilepsy and a few other areas, but there isn't much, yet, around headaches.

The interviewee finds it works well for about a third of his patients.

There are multiple studies taking part now to test keto, with one working very well for diabetes.

He also covered how injuries and infections kick off headaches.

Also covered was to balance things out, like regular sleeping times, meal times, food consumption to minimise migraines.

No diet is perfect for all.

Chocolate can be part of a keto diet, just eat the high chocolate chocolate, not the ones full of sugar.

There have been multiple people posting about it on the forums here and there is more and more evidence that it is helping people.

I've been on a keto diet for a few months now. It has helped with my migraines, given me more energy, made me feel better and as a side effect I've lost over 10Kg (which is welcome). I'd strongly recommend people look at this.

I've just realised that by the time I've posted recommendations for videos to watch, it is late night for those in the US, so hopefully my notes help people.

Day 6 - Botox Separating Fact from Fiction

Botox was used first for neurological treatment for an eye condition, which then became a beauty treatment.

People who think they have tried botox for a beauty treatment and find it didn't help migraine, it doesn't mean that it won't work for migraine as the injection points are different.

Botox is blocking the pain / nerve fibres, which blocks the migraine.

About two thirds of his patients are experiencing medication overuse headaches, so the medications people are using, typically triptans, are causing even more headaches. Equally people can be having medication overuse which isn't (yet?) resulting in medication overuse headache (I suspect the same applies with CH too).

Botox is unusual in that it is an FDA approved treatment for chronic migraine (so many of the medications used for migraine and CH are off label - i.e. they were not FDA approved for how they are being used).

A different protocol was used for episodic migraine, which wasn't successful, however cost is likely to prevent another attempt at FDA approval. However the protocol used for chronic should work for episodic.

An interesting discussion around not always staying on a medication long term, but by trying to wean a patient off a medication once the condition it is being treated is controlled you can tell if the medication is still needed. Obviously this doesn't apply to every medical condition, but it will for many.

50% of people using botox for migraine get a 50% improvement, say 20 migraine days to 10 days, with 25% getting a 75% improvement, say 20 days to 5 days. The remaining 25%'s results weren't mentioned.