Remote Migraine Program
For patients anywhere around the world
Dr. Adam Harcourt is one of the leading doctors worldwide on migraine. Author of ‘Mastering Migraine’, Professor of Migraine Clinical Neuroscience, and co-developer of MQ-7over the years Dr. Harcourt has developed his migraine program to treat each of the 4 main factors of migraine: Hormonal, Nutritional, Musculoskeletal and Neurological. The remote program addresses the first 2 factors: hormonal and nutritional, as these factors (unlike the third and fourth factors) can be properly treated without seeing you in person. Dr. Harcourt is a master of female hormones so you can be sure your hormones will be treated the right way, not with medications, birth control or hormone replacements. Dr. Harcourt uses a top-down approach to truly correct any hormonal issues rather than just treating the end result of migraine. The nutritional edits he may recommend for you are usually closely intertwined and help treat the hormonal factor, so they are very hand-in-hand.
Dr. Harcourt’s 5-Step Plan for Addressing the Hormonal & Nutritional Factors
Step 1: Schedule 30-minute Consultation with Dr. Harcourt to go over hormonal and nutritional history.
Step 2: We ship hormonal lab testing and any needed nutritional supplements to you.
Step 3: You complete DUTCH Laboratory Testing in your home and mail to lab via prepaid shipping label. Begin any nutritional edits recommended by Dr. Harcourt.
Step 4: Dr. Harcourt receives results of lab testing and calls you with interpretation and hormonal protocols. We ship you any needed hormonal supplements.
Step 5: Begin hormonal supplements as recommended by Dr. Harcourt.
1. The Hormonal Factor
The hormonal correlation with migraine has been pretty well known for awhile, but what to do about hormones in migraine is still an ongoing area of debate. Many of our patients had been prescribed birth control or hormone replacement therapies (HRT) by other doctors, which can be helpful in some cases. Unfortunately, there is also research about the long-term effects of some of these treatments which indicate they may lead to other health complications down the line. Many female patients report that they have a flare up in symptoms around the beginning of their cycle, which is why estrogen is often prescribed. I find that estrogen being low or needing to be supplemented is usually part of a bigger problem. Many migraine patients seem to have an increased response to stress and the estrogen changes are more as a consequence of sex hormonal resources being shunted over to stress hormones. This is why we prefer to take a ‘top down’ approach when looking at hormones and also run a comprehensive hormonal panel to see what might be causing the issues. While hormones don’t cause migraine, they play a big role and will make someone much more likely to have a migraine if they are dysfunctional.
2. The Nutritional Factor
A healthy diet and removal of common ‘triggers’ is essential for proper migraine treatment. However, many of my patients have tried just about every diet for migraine and will report that they didn’t help out. This is much more common than you would expect. This is why it’s important to understand that nutritional changes won’t cause or cure migraine, but they are a piece of the puzzle. Some patients have an extreme response to certain foods, histamine responses and/or cross-reactivities, so making these seemingly simple changes may drastically improve their migraine days and intensity. However, if dietary triggers aren’t a big contributor to another patient, they can try every diet and supplement under the sun without seeing much of a change. This is why we focus on not only looking at the current research on migraine and diet, but also blood sugar and other common factors that make people more likely to avoid migraine. The nutritional edits are never meant as a cure-all, but as a baseline so we don’t miss something simple that is slowing down or impeding progress. So if you’re one of those people that has tried every diet, just remember it’s only one piece of the puzzle and there is much more to migraine that needs to addressed.
3. The Musculoskeletal Factor
Any increased physical stress on the body will make a person more likely to have migraine. This is why the research shows positive outcomes for migraine with almost any body work type of therapy. There is good research for massage, acupuncture, chiropractic, and exercise. These are all great modalities, but the one thing they have in common is that they reduce the amount of musculoskeletal stress on the system. However, because any of these techniques can cause short-term inflammation, the initial effect may actually be an increase in symptoms. This is why it’s important to understand that something that seemed to have made you a little worse may not have been a bad treatment, it just may have been too much treatment at that time. Another consideration is that each of these modalities impacts the nervous system a little differently. The pathways stimulated by acupuncture are different than the ones stimulated by massage. So if you have migraine and your main neurological dysfunction is located in an area that is not impacted by massage, it might look like massage isn’t that helpful. Your friend that has migraine may have dysfunction in an area heavily impacted by massage, so they may see more of an improvement. This is why a thorough functional examination is so important to understanding which modality will be most beneficial.
4. The Neurological Factor
The neurological component has 2 aspects to consider. The first is the genetic predisposition to migraine. Migraineurs have an altered brain state that is different from people that don’t have migraine, even when they are not having any symptoms. The way this seems to present is through certain pools of neurons being more likely to fatigue or fail, leading to symptoms associated with migraine. For example, if your genetic predisposition is in an area associated with pain inhibition of the face, and that area fails, you’ll experience a migraine. If your predisposition is in the area associated with sight, you’ll have visual symptoms. If it is in the area associated with balance, you can experience dizziness. The underlying pathology is basically the same, it just impacts different parts of the brain and brainstem. Therefore, the basic idea behind the neurological component is to identify the areas of the brain that are functionally not as healthy as the others, and stimulate that part of the brain at an appropriate level. Too much stimulation can actually lead to a migraine, and too little won’t make much of an impact. This is why we use a graduate approach in which some people will be given a great amount of stimulation right away, and some get very little. The key is to continually strengthen these parts of the brain, and essentially ‘make the bucket bigger’.
The other aspect of the brain has to do with injury and general neurological dysfunction. It is very common, for example, to see someone who gets in a car accident or has had a concussion to have a noticeable increase in migraines. It’s not that these injuries caused migraine, but the stress on the brain and nervous system makes them more likely to have migraine. This can also happen with vestibular imbalances, difficulty with eye or head movements, or difficulty with motion. Improving any of these aspects will help move you down the spectrum of migraine to have less and less.
Dr. Harcourt’s Bucket Theory
Picture the part of your brain that allows migraine to occur as a bucket. All migraine patients have different size buckets – some very small and some larger. The smaller the bucket, the faster it will fill up with stress and triggers and overflow into a migraine. One of the goals of our migraine program is to make your bucket as big as possible. This will allow you to be able to handle a lot more stressors without your bucket overflowing and causing a migraine. We do this with neurological rehabilitation, peripheral nerve stimulation, gaze stability exercises, vestibular rehabilitation, manual therapies, eye-head tracking exercises, and/or peripheral vision training. The bucket can also be in different parts of the brain, which is why different treatments are effective for different patients.
Affordability of the Program
Did you know that for those who have tried more than two preventative migraine medications, the mean all cost is $18,394 per year??? The vast majority of the patients we work with have tried AT LEAST two medications, so this means that you probably fall into this category as well.
- Missed work
- Trips to the E.R.
- Urgent Care/Doctor Visits
- Over-the-Counter Medications
- Natural Remedies
All add up to an average spend of over $18,000 per year per patient!
For example, the new CGRP-blocking medications like Aimovig or Emgality cost $6000-9000 per year, and only give a 50% reduction of migraine days for less than half of patients. People all over the world are shooting in the dark, spending money on anything they can find that might help.
With my program, you’ll be:
- Treating these factors the RIGHT way
- NOT shooting in the dark
- Understanding your most weighted factors
- Learning how to stay IN CONTROL of migraine long-term
- Joining a team who will support you for years to come
$2500 for Entire Remote Program*
- Hormonal Laboratory Fees
- Hormonal Supplements
- Nutritional Supplements
- All Consultations with Dr. Harcourt
Total Length of Program is approximately 3-4 months, depending on the results of hormonal testing and amount of treatment needed.
Most PPO insurance plans will reimburse you for the laboratory fees and consultation codes we will be using during your program. We will provide you with a ledger/superbill to submit to your insurance. Actual reimbursement depends on your plan coverage. We are happy to help with this as much as we can, but any coverage question will need to be directed to your insurance company.
Dr. Adam Harcourt
DC, DACNB, FACFN, FABVR
Call Now to Set Up a Free Phone Consultation with Dr. Harcourt