Dr. Ronald Lavine practices chiropractic in New York City and Princeton, NJ

There’s a new class of drug — CGRP inhibitors — that’s being used to prevent migraine. Two popular examples are Emgality and Nurtec.

These drugs block the action of calcitonin gene-related peptide (CGRP). CGRP is part of the signaling system that sensory neurons (especially those of the head and face) use to tell the brain that they’re experiencing an intense stimulus which the brain then interprets as an experience of pain. So if you can block this chain of events, you can alleviate or even prevent a migraine attack.

That’s a good thing.

But the CGRP-signaling system also has a positive side, and blocking it could cause other problems.

When CGRP is released in the gut, it tells the cells lining the stomach or intestine to produce more mucus. The extra mucus protects your stomach or intestinal lining from chemical damage, bacterial attack, or irritation.

Blocking your protective mucus secretions isn’t a good thing. That may be why some of the commonly-reported negative effects of CGRP inhibitors are nausea and vomiting. Even if you don’t get nausea or vomiting when you take these drugs, they still may be causing subtle long-term damage to the gut lining.

I’ve had patients with migraine attacks so severe and so frequent that they were willing to do nearly anything to get relief. Perhaps in some cases the relief they get from Emgality or Nurtec is worth the risk of negative effects.

Still, it’s important to be aware of the limitations of the allopathic medical model which blocks symptoms rather than fundamentally alters your internal state of health.

If you are taking one of these drugs, you can also take steps to strengthen your mucus barrier. One of the simplest ideas is to use the herb slippery elm.

I can suggest additional nutritional and herbal strategies if you need a more comprehensive approach.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.

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