14 yr old son suffering

I had migraines all through childhood but only got diagnosed much later. No actual advice to offer but I'm just glad to hear he is getting treatment as a kid because years of untreated migraines messed me up. 

I guess my non-pharmaceutical suggestions would be a headache hat and tiger balm.

My son was started on a low dose of Amitriptyline in his early teens. It has reduced his 12-15 migraines monthly to maybe 2-3 mild headaches a month. He takes it at night because it can make you sleepy. It also cured his stomach pain that doctors couldn’t find a reason for.

God I fucking hate migraine. So sorry your son has to suffer as well

I started getting brutal migraines beginning in 2001.

I saw several neurologists, took different medications and nothing really helped.

In 2011, I started taking fish oil with high DHA daily. Since then, my migraines have dropped 95% overall. Fish oil helps lower migraine pain.

It's been a miracle. I've been preaching this for years to whomever will listen, hoping to help.

There is also a vegan DHA substitute for vegans.

I can show you what I take if you want.

https://www.nccih.nih.gov/research/research-results/diets-higher-in-omega-3-fatty-acids-reduce-headache-frequency-and-severity-in-people-with-frequent-migraines

Are you in the US? If so, what state? My best advice (as a teen that started dealing with migraines in high school) is if you have a good children’s hospital near you to get established with a headache specialist there. Children’s hospital are going to be best equipped for navigating medication for minors.

This study showed success using botox for pediatric migraine patients:

Experience of Botulinum Toxin A Injections for Chronic Migraine Headaches in a Pediatric Chronic Pain Clinic
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887883/

My neurologist does botox for teenagers but it’s probably dependent on the headache specialist and your insurance

I (21 now) have gotten hemiplegic migraines, cluster headaches, ocular migraines, and chronic migraines since I was 8.

My sister (17 now) has gotten chronic migraines and ocular migraines since she was 9.

I’ve struggled with some truly awful migraines since I was 8 years old (21 now) and it was not a fun time. My sister was 16 when she got placed on preventatives for her’s. She was placed on Amitriptyline and Nortripyline as a preventative. For break out migraines, she’s on Maxalt since she’s considered too young for Nurtec and she takes it with two advil. That helps her the most! It’s been a year and she hasn’t had to be changed around too much.

I will say, the biggest struggle we had with my sister is getting her the medication she needed as a minor. Her pediatrician was only legally allowed to give limited doses of stuff and we ended up switching her to my primary doctor. Both her and I see the same pediatric Neuro though (I actually see him in the morning lol).

Another thing that helps my sister a lot is taking dietary supplements like magnesium and a multivitamin.

If your son hasn’t been tested for allergies, I highly recommend it. Both my sister and I have noticed that our migraines aren’t always hormonal but born from allergies we didn’t know we had til being tested. For instance, environmental allergies and in my case certain foods like pasta or things that have a ton of gluten and/or wheat.

Another variable is heat, I’m actually in the process of transferring from my university because the humidity and heat is so bad in the summers in the US in that area, that I would get a migraine within a five minute walk to class. It was not very good for my studies to say the least.

Finally, it’s really hard to have migraines in general as a minor as you and I’m sure many on the sub know. I lost several friends because of them and so has my sister. But what we do find are friends and activities that keep us connected to the world the best we can. I can’t really recommend much to lift his spirits but for him to have a mom that’s willing to do go out of her way to post about his struggles and to try to find ways to help deeply warms my heart. I wish I had a mom when I was that young who not only knew the deal but worked hard to and was even willing to ask total strangers on the internet for help. Fortunately, once I was old enough and enough bad things happened to me because of migraines, I was able to fight for my sister and I (and even my mom!) to get the help we needed.

I hope this helps somewhat! I’m sure other people have much better advice than I but I couldn’t help but give a bit of my input anyway. Good luck to your son!!!

I was 14 when they invented triptans and first tried them. They were a miracle for me (still are!). Has he tried zolmitriptan, sumatriptan, etc?

I’ve suffered from migraines since early childhood and started getting treated for them when I was about 14 (yep, took at least a decade for anyone to listen to me…) i actually had a much better experience when I started seeing a regular neurologist (not a pediatric neurologist) because I got access to triptans. My insurance didn’t cover them until I was 18 (possible that’s changed… this was a good 20 years ago), but my neurologist gave me samples until I could get them covered.

Migraines suck. They’ve been so much easier to deal with as an adult (and before that, college student) than as a high school student.

My 15 year old started to get them around 8. The Botox didn’t really help him and insurance won’t approve it for him. He’s currently in a beta blocker and acetazolemide (it’s an altitude sickness pill). His triggers are weather and lack of sleep/stress.

Daughter since age 9 has been taking maxalt with good results.

I've got a middle schooler who has been getting migraines since he was about 3 years old. I didn't realize what was going on until he was 6 years old though. His father and I are both migraineurs, so I already knew most of the tricks. We do have a pediatric neurologist at this point, but most of the stuff I was already doing before we saw the neuro.

There are a lot of vitamin supplements that you can use that are safe for kids and will help prevent migraines. Might not prevent ALL of them, but my son went from 1-2 per week to 1-2 per month just from adding supplements. I'd recommend starting 1 supplement at a time and giving a few weeks to adjust before adding another one. That way if one of them is causing something like upset stomach, you know which one it is.

I'd start off with Magnesium Glycinate at bedtime. It makes most people a little sleepy, so that's why bedtime. You'll see adult doses of up to 400mg, but don't start high. You can buy some 100mg pills and start there, or even split that dose in half if you want to be extra careful. My kid is small and takes slightly less than 100mg.

Our pediatric neuro is also really big on B2 aka Riboflavin as a preventative. My son takes some, but not as much as our neuro suggests.

Another one that REALLY helped my son was a little bit of melatonin at night. This one is a little trial and error, because for some people it helps, and for some people it makes them worse. I don't know if it's the melatonin that's helping or if he's just getting more/better sleep, but something about it works, so we keep it.

I'm sure you already know about lifestyle stuff, like making sure you get enough sleep, don't go too long without eating, don't try to make a meal out of a candybar or piece of cake, stay hydrated, etc. Those can be really hard with kids because they're old enough that you aren't dictating everything they do anymore like when they were 3, and they can end up making a lot of choices that trigger the migraines without understanding how badly it's going to hurt them in a few hours. Just because their friends can skip dinner and then drink a McFlurry doesn't mean they can!

I'm going through this now with my 10 year old. He's missed most of his school year. Migraine sucks.

There's a lot of literature in the medical community outlining the steps for migraine treatment in peds and adolescents. When neuro follows these steps and rule out possible solutions, insurance will start to consider covering other more expensive options. Treatment is trying a lot of things that don't work until something shows a glimmer of helping, then optimizing that.

The first preventative to try is vitamins. Low risk, potentially great reward. Takes up to 2 months to make a difference. I feel they help make my migraines fewer and less intense.

B2 (riboflavin) 400 mg every morning. At the same time every night, about an hour before bed: Magnesium Oxide (most studied form in pediatrics) 400 mg and up to 5 mg melatonin (my son takes 3mg, but I only tolerate 0.5mg- start low and experiment).

After 2 months, they may consider amitriptyline or propranolol. Maybe topamax. The potential side effects for propranolol are the least scary of the bunch. Be careful for SI and depression with the others.

After that, they will likely have more insurance clearance for nerve blocks or the newer Ubrelvy or Nurtec, inpatient treatments, Botox.

Also note it is important to keep a headache diary to show the severity of your son's disability and to identify possible trends and triggers.

Not sure about triggers and such, but yes, the hormones in boys are just as strong as the ones in girls

I went on topamax as a kid and have been on it ever since! With the newer class of medicines coming out I’m not sure if there’s a better one out there/approved for kids. I saw a pediatric neuro at that age and she was such a blessing for me and my parents, really explaining and helping us understand everything!