Why Are So Many People Plagued by Headaches?

Summary

ALL OF IT Podcast Summary: "Why Are So Many People Plagued by Headaches?"

Episode Release Date: July 21, 2025
Host: Alison Stewart
Guest: Tom Zeller, Jr., Author of "The Science of a Most Confounding Affliction and A Search for Relief"

---

Introduction

In this engaging episode of ALL OF IT, host Alison Stewart delves into the pervasive issue of headaches, exploring their various types, underlying causes, and the significant impact they have on individuals and public health. Joined by Tom Zeller, Jr., a seasoned journalist and author, the conversation blends personal experiences with scientific insights to shed light on why headaches remain a challenging medical ailment.

Understanding Headaches: Types and Differences

Tom Zeller introduces the audience to the different categories of headaches, emphasizing that not all headaches are created equal:

• Cluster Headaches: Affecting less than 1% of the population, these are characterized by sudden, intense pain without warning signs. "The pain is debilitating. You can't do anything when a cluster headache is firing at its peak," explains Zeller (02:08).

• Migraines: The most familiar primary headache disorder, migraines involve recurring headaches that can be severe but are generally more manageable with over-the-counter medications.

• Tension-Type Headaches: More common and often less debilitating, these headaches respond well to simple treatments and lifestyle adjustments.

Zeller elaborates on the complexity of distinguishing between these types, highlighting the unique physiological processes each entails.

The Personal and Public Health Impact of Headaches

Headaches are not merely personal nuisances; they pose a significant public health challenge. Zeller references his book to discuss the staggering prevalence of headache disorders, affecting approximately 3 billion people worldwide. He emphasizes that migraines, cluster headaches, and related conditions are among the most harmful to public health when measured by disability-adjusted life years (DALYs).

"It's a way of comparing all these things and ideally giving funders and scientists some idea of where the greatest needs are, where money maybe should be spent." (08:39) – Tom Zeller

Zeller expresses surprise at the relatively low funding headache disorders receive compared to their impact, underscoring the need for increased research and resources.

Challenges in Diagnosing and Treating Headaches

The episode explores the difficulties patients face in obtaining accurate diagnoses and effective treatments. Zeller discusses the skepticism patients often encounter from healthcare providers, especially since headaches like migraines predominantly affect women—a fact that has historically led to their trivialization.

"Doctors have not always been great at taking us seriously," Zeller notes, highlighting the gender bias in medical treatment of headache disorders (11:08).

Listeners share their struggles with finding effective medications. For instance, caller Robin from SoHo recounts the trial-and-error process with various drugs, culminating in the discovery of effective but side-effect-laden medications like Imitrex and Hewilipta.

Advances and Future Directions in Headache Treatment

Despite the challenges, there have been significant advancements in headache treatment. Zeller discusses the emergence of CGRP (Calcitonin Gene-Related Peptide) medications introduced in 2018, which have been life-changing for many sufferers.

"If a drug helps half the people, half the time, you're sort of on a winner," Zeller explains, acknowledging both the promise and the limitations of current treatments (17:42).

He also touches upon ongoing research into other neurotransmitters and potential therapies, offering hope for more effective solutions in the future.

Listener Stories and Experiences

The episode features heartfelt accounts from listeners dealing with chronic headaches:

• Meryl from Port Washington shares her journey through misdiagnoses and ineffective treatments before finding some relief through serotonin-related therapies (13:04).

• Robin from SoHo describes decades-long battles with migraines, highlighting the emotional and physical toll they take despite finding some effective medications (14:29).

• Ben from Brooklyn discusses his struggle with vestibular migraines and the surprising efficacy of antihistamines like Zyrtec in reducing his migraine frequency (20:10).

• Cheryl from the Berkshires opens up about childhood-onset headaches and her strategy of using motion sickness medication to alleviate nausea during severe episodes (22:46).

These stories underscore the diverse experiences of headache sufferers and the urgent need for personalized treatment approaches.

Historical Perspectives on Headache Research

Zeller delves into the history of headache research, particularly focusing on Dr. Harold Wolf, a pioneer in the field. Wolf's emphasis on the brain's vasculature as the primary culprit in headaches has shaped much of the scientific understanding, though contemporary research suggests this may have led scientists down a "blind alley" (25:28).

Impact of Environmental Factors

The conversation also touches upon how environmental conditions, such as barometric pressure and elevation, can trigger headache attacks. While acknowledging anecdotal evidence, Zeller emphasizes the multifactorial nature of headaches, making it difficult to pinpoint exact causes (22:42).

Conclusion

As the episode wraps up, Zeller reflects on his personal experiences with headaches and the gradual improvement he's observed over the years, attributing it to a combination of aging and effective treatments like CGRP injections (29:33). He underscores the importance of ongoing research and the evolving landscape of headache treatment, offering hope to millions affected by these debilitating disorders.

"We haven't hit a wall, but we've definitely taken a long time to start taking them seriously scientifically." (27:44) – Tom Zeller

ALL OF IT effectively combines expert insights, historical context, and personal narratives to provide a comprehensive exploration of headaches, their impact, and the journey toward better understanding and treatment.

---

For more episodes and to join the conversation, visit WNYC's ALL OF IT. Share your experiences with chronic headaches by calling 212-433-9922 or texting the provided number.

Transcript

[Alison Stewart]

This is all of it. I'm Alison Stewart live from the WNYC studios in soho. Thank you for spending part of your day with us. I'm really grateful that you're here. On today's show, the stars of the darkly funny musical Heathers joins us in Studio uk. Soul artist Omar will be here for a listening party for his latest album titled Brighter the Days. Plus, we'll talk with two food writers from Grub street about the best food that they have eaten so far this year. And you should call in and share what's on your list. That is our plan. So let's get this started. Headaches are one of the most common medical ailments, and yet they remain poorly understood. There are lots of different kinds of headaches that might spring up for different reasons, and they're not always predictable, which makes them hard for researchers to study. Still, when compared with other afflictions, migraines, cluster headaches and other members of this category are listed among the most harmful to public health according to one common metric. If you're one of the 3 billion people around the world with headache disorders, you might want some answers. A new book called the The Science of a Most Confounding Affliction and A Search for Relief is by Tom Zeller, Jr. A journalist and editor who has known a bit about dealing with a particular disorder known as cluster headaches for many years. In the book, he blends his personal experience with historical research and scientific reporting to explain the latest on headache research and why it still can't answer many of the essential questions that stand in the way of treatment. Tom Zeller, thank you so much for joining us.

[Tom Zeller]

Thanks so much for having me, Allison. It's great to be here.

[Alison Stewart]

One of the reasons you wrote the book is your own experience with cluster headaches. What are cluster headaches?

[Tom Zeller]

Yeah. So cluster headaches, probably unfamiliar to a lot of listeners. They afflict only less than 1% of the population. They're different from migraines. The pain comes on very, very quickly. You don't usually get any kind of warning signs and it doesn't work up. It shoots up to 11, as you might say, almost immediately, and the pain is debilitating. You can't do anything when, when a cluster headache is firing at its peak and it, it really does. I, I liken the intensity of it to having your hand on a hot burner but not being able to take it off. It's kind of at that level of intensity for about an hour, maybe two. If you can't medicate it in any way and then, and then it vanishes and you're perfectly back to normal. But then it might come back again another two or three hours later. And this will happen every few hours throughout the day for a couple months out and then, and that's where the name comes from, it happens in a cluster around the year and then they go away and you might have many months or even years in between attacks. Very different from migraines, but probably very similar physiology happening in there.

[Alison Stewart]

Well, can you explain what some of the other headaches are for the sake of this discussion?

[Tom Zeller]

Yeah. So migraine is probably the most familiar of the. They call them primary headache disorders. And these are disorders that are distinct from, you know, the kind of headaches that we all get if you skip lunch or, or you are a bit dehydrated. But the headache itself is the disorder. It's sort of the salient factor of the disease. So migraine is probably the most familiar of them. Cluster is another tension type headaches are probably the most familiar. These are recurring headaches, but they're often more treatable with over the counter medications or maybe some lifestyle changes and they tend to be less debilitating and then they go down. There's a whole, whole gamut of other very sort of more rare primary disorders from trigeminal neuralgia and lots of other ones with fancy names, but those are the main categories and probably the ones that anyone who has a headache is probably most familiar with.

[Caller]

In your book, you write, this is not a textbook. I am not a scientist nor an academic.

[Alison Stewart]

So what did you hope to accomplish.

[Caller]

By writing this book?

[Tom Zeller]

Yeah, so, I mean, it's funny, I, I don't think I ever wanted to write about headaches. It never occurred to me in all my life as a journalist. I covered a lot of other things, but when it came down to writing a, a book, part of it was, you know, what do I know about. And, and strangely, this is something that I know rather intimately. And I know that in part because I was always struck during my, you know, when these first came out in my 20s, I'm in my 50s now, but over, you know, over the decades, I would get online and I would look at the literature, I would read the scientific literature, I cover science as a journalist. So it was familiar to me. And I was always struck at how little was actually known. It seemed to me that, you know, headaches are common enough especially, and even headache disorders like migraine or cluster headaches are common enough that it surprised me that there wasn't more known about this. So the journalist in me thought immediately, well, let's find out why.

[Caller]

You're a writer as well as being a journalist, and you have to put into experience what pain is, what it feels like. I mean, you go about quoting writers like Virginia Woolf. What is it about headaches that are difficult to describe to someone?

[Tom Zeller]

Yeah, well, on the one hand, I think it's difficult to describe in part because we all think we know what it is, because we all. Well, I'm sure there are people who don't, but most people do know what it feels like to have a pain in the head. If you're, say, dehydrated or as I mentioned, you skipped lunch or maybe you had one too many cocktails the night before and you get kind of a dull ache all around the head. That's a different animal. And it's unfortunate in a way that we just colloquially use this word headache to refer to a lot of different things that run the gamut from what I just described to truly like, debilitating pain disorders that prevent a person from fully participating in the culture and in the economy and really can be quite debilitating. So in some ways, I think that pain is hard to describe to people because we use the same word for both. I also think that there's something rather different about pain that's happening inside the head. And I try to get at that versus, you know, I describe in the book that I've had ankle surgery, for instance. I'm a runner and I busted a couple tendons. And, you know, the surgery was quite painful, the recovery was quite painful. But it did always have this sort of geographic distance from me. It was kind of down there. But once the pain starts to move up into your head and we're talking severe pain, like sort of pain that feels like an emergency inside the nub of the self, it becomes hard, hard to distinguish, like, where does the pain begin and I end? It's all kind of sort of mixed up in there. And so there is. I feel like there's sort of a different aspect to that, particularly when you're talking about really powerful headache pain disorders.

[Alison Stewart]

We're talking about the new book, the the Science of a Most Confounding Affliction and a Search for Relief with its author, journalist Tom Zeller. Listeners, if you'd like to get in on this conversation, if you'd like to share your experiences with chronic headaches or your experience trying to get relief from them, our lines are 212433, WNYC. You may call in or text, or you can hit us up on our socials. Lovenyc. Perhaps you can share what's worked for you. Our phone number is 2124-3396-9221-2433. WNYC. You know, there's a section of your book where you talk about the attempts to sort of quantify the impact of headaches as a public health issue. And one of the most common metrics used is called the disability adjusted life years. First of all, what does that mean? And why is it important to public health officials to compare health conditions that way?

[Tom Zeller]

Yeah, so it's a metric used to sort of collapse the distinction between say, a disorder like headaches and accidents that sort of injure or kill people and other diseases like cancer or, you know, aids, whatever it is. So it's a way of sort of quantifying both diseases that both shorten lives and also rob people of productive years. So if you, it allows economists to sort of put all these things on the same plot and say, okay, well, how does the burden of cancer compare to the burden of, say, migraine or to the burden of gout or to the burden of sciatica or to the burden of car accidents or to the burden of gunshots? And so it's, it's a way of sort of comparing all these things and ideally giving funders and scientists some idea of like, where the greatest needs are, where money maybe should be spent. And, you know, it has its critics, but it is a sort of interesting way to look at diseases and accidents and the human condition.

[Alison Stewart]

So you may ask somebody, how many disability adjusted life years have I lost due to headaches?

[Tom Zeller]

Yeah, that's one way to think about it. I mean, it's a little overly simplistic, but it definitely aims to say, okay, how often is a person suffering from migraine behind closed doors, can't work, has their head under a pillow, and is basically functionally disabled for as long as that headache is grinding on. It doesn't kill them, of course, but it is robbing time from them, leading a productive and healthy life. So if you were to add up all those hours and all those days over the course of a person's lifetime, what would that look like? And that's what the daily tries to get at.

[Caller]

Doctors are not always perfect. They have good reasons to be skeptical, to be thorough, to be evidence based. But it seems like with headaches it requires them to believe their patient.

[Alison Stewart]

Basically.

[Tom Zeller]

Yeah, yeah, go ahead.

[Caller]

No, I was going to ask, does that create difficulty between patient and doctor, especially the way that doctor's appointments go these days.

[Tom Zeller]

It can, yes. And I think headache has a sort of a special place in there. And one reason for that, and I do address this in the book, is that particularly with migraine, this disorder affects women over men by a ratio of something like 3, 3 to 1. It's much more prevalent in women. And when you have a disease that has no biomarkers, there's no clear sort of test to sort of say, oh, okay, yes, you have migraine, you've got the biomarker for migraine, or you've got the biomarker for cluster headache when you don't have that. And when you have a disease that's particularly prominent in women. We all know that women's health has received short shrift over the decades. It was very easy and very common, I think, for doctors to attribute it to, you know, either psychogenic or psychosomatic origin, or we all know the word hysteria or women are just too stressed out. So it was a way of. It really did suffer over the decades from being trivialized and sort of over simplified in part because it's a hard nut to crack. It's very difficult to sort of discern what it is that's going wrong in there. So there were a lot of pat explanations for that. And I talked to a lot of women in this book who even today still get sort of a residue of that from their doctors. Now, I think times have changed and I don't want to besmirch a profession saying that they're all sort of being dismissed, but that does sort of operate in the clinician's office. And I do think that we're still sort of coming out from under that.

[Caller]

Tom, let's take some calls. Let's talk to Meryl, who's calling in from Port Washington. Hi, Meryl, thank you for making the time to call all of it today.

[Meryl]

Hi. Mine started only a few years ago, but it was sort of dismissed at first as just, I don't know, maybe anxiety or whatever. Then it went to, I had migraines and was given culy, which didn't work. Then I was given shots that didn't work. And then finally some other neurologist decided that I had venous insufficiency through my arteries in my neck, gave me surgery to which I really didn't have that either. So my husband gallantly found me, through friends, a very qualified neurologist who diagnosed me with serotonin levels that might be too low because what I Feel is not a traditional headache, but more of like head pressure. And so it feels like I'm wearing a headband around my head, you know, all the time. So that I've been doing for the last year and a half and that has seemed to help it somewhat and depending on how I eat as well, tends to make me feel more comfortable with it. Like today I feel good, but when it's depending on weather, sometimes it feels really bad.

[Caller]

Again, Meryl, thank you so much for sharing your story. Let's talk to Robin, who's calling in from SoHo. Hey, Robin, thank you so much for calling all of it. You're on the air.

[Robin]

Oh, thank you so much. I really appreciate this conversation. I have been suffering with migraines since my 20s. I think I thought it was hormone, hormone related. I'm now over 65. And so all these years I've gone through like really bad migraines with throwing up and being nauseous and sometimes nine days in a row of migraines. And then I discovered Imitrex when that first came out and it really helped. And then I've been taking that for a while until my doctor said, well, I'm nervous about you being on Sumatriptan now because there is a possibility of strokes. So scared me to death. Put me on five different medications. One of them made me depressed, one suicidally depressed. One of them didn't work at all. All of them had difficult side effects. Hewlipta has really helped, but there's a side effect with that which is really uncomfortable. So I'm at a loss. I just feel like this is one area that medicine and doctors are not able to really come up with something that works for all of us. And I know we all have different kinds of headaches, but thanks for your book. I'm going to read it.

[Tom Zeller]

Yeah. Thank you.

[Alison Stewart]

Yeah. Tom, I'd like you to respond.

[Tom Zeller]

Yeah. I mean, what's being described here is so common among headache sufferers and that is the level of polypharmacy, which is, you know, the number of drugs a person is on at any given time among headache patients is akin and sometimes exceeds that of geriatric populations where it's much more common to be taking multiple medications. So the sort of gauntlet that headache sufferers have to go through in order to find something that works, if they're lucky enough to find something that works, is really sort of prominent. And the stories are incredibly common. One reason for that, I should point out, is that for all of headache history, there really has never been a medication developed by the pharmaceutical industry or by institutions that was designed to treat headache. For most of history, it was always a hand me down drug that was developed for, say, depression or developed for epileptic seizures or developed for other conditions that seem to have maybe some effect on alleviating the headache. So they would prescribe that to a headache patient just like your caller. And they always came with some really nasty side effects that were unfortunate and maybe alleviated the headache sometimes, but often presented with other side effects that were less than ideal. So it really is only in 2018 that drugs sort of entered the market that really were designed specifically for migraine and for cluster headache. And I would think if your listener hasn't tried that, if the caller hasn't tried those, they're CGRP medications is what they're called. I would highly suggest talking to a doctor about those.

[Alison Stewart]

We're talking about the new book the Headache the Science of a Most Confounding Affliction and a Search for Relief. Its author is Tom Zeller. He's our guest. We'll have more of your texts and calls and more about what we know about headaches after a quick break. You're listening to all of it on wnyc. I'm Alison Stewart. My guest is journalist Tom Zeller. He's written a book called the the SC of a Most Confounding Affliction and A Search for Relief. You go into the history of how medical professionals addressed headaches from ancient Egypt through Charles Darwin's father, through today, knowing now what you know, was there anything that either surprised you or really made sense to you about how we treat headaches?

[Tom Zeller]

I mean, I think both are true. That's a great question. I think both are true. I mean, one thing that's I went in rather surprised that we knew so little. And, you know, as I, if I started to uncover the neuroscience, it becomes a little more reasonable that, you know, let's face it, the central nervous system in particular our brains are still rather mysterious organs. We don't even really fully understand what normal function might look like, much less abnormal function. And it's hard to study. That said, it was surprising for me to learn just how orphaned migraine in particular and other headache disorders are compared to other diseases. In terms of what we're willing to fund and what we're willing to research, I was rather surprised to learn that despite having a rather large burden on people's lives, according to that daily metric that we talked about, migraine in particular is very underfunded it gets very little money from the National Institutes of Health for basic research into figuring out why it happens and how perhaps we could cure it. And that was sort of surprising to me. Given the outsize, the huge economic toll that migraines take, you would think that there would be more interest in getting to the bottom of it. I do think that's changing, but I was surprised by that.

[Alison Stewart]

Let's talk to Ben, who's calling in from Brooklyn. Ben, you're on the air.

[Ben]

Hi, delighted to be on the air. Thank you for shining some light on this issue. I have been struggling against very difficult to diagnose migraines for the past 15 years. I remember sitting on the floor when I was a senior in high school and feeling this crazy electric sensation overtake me and then being dizzy for about a week and a half with what I later learned was something called a vestibular migraine that impacts your inner ear. Who knew? It took a decade to figure out, and even our understanding now of it is tentative. What I wanted to ask was about if you're aware of any relation that histamine has in migraines. One of the things that was surprising was that I started taking Zyrtec and my migraine frequency dropped in half. And that was just stunning to me. And I still don't have a perfect answer of why that is.

[Alison Stewart]

That came up in your book?

[Tom Zeller]

Yes, it did come up in the book, and it's a great question. I don't. So I will say this. Histamine definitely is a known trigger of headache in a lot of people. So if you're prone to getting migraines, if you're prone to getting even clusters in an experimental setting, histamine is known to trigger those bouts fairly reliably. Not in everyone, but in a high percentage of volunteers and studies, histamine will trigger those headaches. And so there is a theory, a working theory that's been around for decades, that if you. You slowly desensitize someone's system to histamine by sort of giving them small infusions that are sort of titrated upward over time, you might be able to cure their headaches. And there are clinics that will provide that, provide that treatment. Even now, not everyone buys this. There are lots of other compounds and substances that we can use to trigger a headache, but that they don't really necessarily lead to a cure. Nitroglycerin is one example. We can almost always bring on a headache and a migraine in a person prone to this. But with that Said, I don't think it's unusual to think that histamine may be playing some role in some people's headaches. And if it is working for you, I mean. Enough said. I mean, people usually have to kind of find their own, choose their own adventure when they're trying to treat their own headaches. And if. If taking Zyrtec reduces your headache, then by all means, keep taking it.

[Caller]

Let's talk to Cheryl in the Berkshires.

[Alison Stewart]

Hi, Cheryl. Thanks for calling, all of it. We got a lot of questions about.

[Caller]

What you have a question about.

[Cheryl]

Oh, good. Well, thank you for having me on today. And it's actually really great to hear this subject covered. In fact, my husband and I were talking about it the other day. I've been suffering from a lot of the headaches that you've described since the age of 10. I'm now 50 plus. A hack I did want to share for those who get nauseous is to use motion sickness medication right when a bad headache comes on, because I found that has helped me a lot. But my question is one of the headaches that I've been suffering from, actually during this summer, many mornings I'll wake up with a headache which I think is affected by the bar or created by the barometric pressure. I've noticed that for many years now. But it's been especially, I think, daunting this past. You know, during this summer, you come across this.

[Tom Zeller]

I definitely have come across anecdotal evidence and some clinical evidence that environmental conditions can bring on attacks. Whether it's barometric pressure, even something like elevation can affect headache attacks. The problem is that, like, it's almost. It's certainly a multifactorial disease. So it's really hard to say.

[Andrea]

Even.

[Tom Zeller]

If the barometric pressure is affecting your headache or is a trigger for your headache, that it would be sort of a trigger for everyone else. Everyone's bodies are so different. So I definitely have heard that this kind of thing can happen. One other thing I'll note is that with cluster headaches and possibly with migraine too, the hypothalamus, which is sort of the center of our circadian rhythm, it's sort of the biological clock inside our brains is definitely implicated in both. Both of these headache disorders. We're not sure exactly why, but it definitely lights up when people are experiencing these things. And that. That organ, that part of our brain is. Is acutely attuned to our environments in all kinds of ways. So it's almost certain that all of that is kind of Playing a role. We just don't know who the primary actors are and who the extras are.

[Caller]

We're talking about the new book the Headache the Signs of a Most Confounding Affliction and a Search for Relief with its author, journalist Tom Zeller. One of the that you spotlight in the book is a New Yorker named Dr. Heron Wolf. And in the middle of the 20th century, he was one of the first to establish that migraines had a sort of a hereditary element. He was also interested in the mind and the body and in the environment when it came to nervous system disorders. What did he study that you found interesting?

[Tom Zeller]

Well, it's interesting. I mean, there's no question. I think there are awards even in the study of headache science that are named after Harold Wolff. He's sort of of the sort of founding father of headache science in a lot of people's estimation, and he celebrated in that regard. But there's also some. There's a movement now which surprised me to learn that sort of looks at his fascination in particular with the vasculature of the brain. So blood flow within the brain as a possible culprit, as the probable culprit in most headache disorders. And I think that a lot of us have inherited that sense. Like if we think about what is a headache, what's happening in the head, we all kind of reflexively think, well, there must be blood flowing up in there too much. It's like the blood vessels are expanding and they're pressing against a nerve or something. And Harold Wolf, I think, also believed this in some way and helped perpetuate this notion. We're now learning that it's almost certainly not true and possibly that the blood vessels may not be involved at all. And so what surprised me most is that, you know, this. This figure who's such a giant in headache science actually may have led us down what one of the other scientists I spoke to a contemporary science described as a blind alley, a sort of wrong direction.

[Alison Stewart]

Let's talk to Andrea calling in from Brooklyn. Hi, Andrea, thank you so much for making the time to call, all of it.

[I]

Well, thank you for taking my call in. It's Andrea. Andrea, I'm the girl who voted for Brian Larrey three times for mayor. Just saying so. Just had to say it out loud. Your person took that information. Actually, she said she would tell them so. My mom has Alzheimer's and she is on Calypso. She's 88. She's on Calypta Ubrelvi. She's done three months of Botox, and still we can't figure it out. So when I saw my neuro recently, which is now her neuro, I said, what do we do for her? And she said, we're. That's it. That's all we have.

[Alison Stewart]

Huh.

[Tom Zeller]

Huh.

[Alison Stewart]

So you bring an interesting question, Andrea. Why have we hit a wall when it comes to medication?

[Tom Zeller]

Tom yeah, that's. So you can look at it two ways. I mean, some would argue that we haven't hit a wall, that in fact, we're in an era of great flowering. And these new CGRP medications that I ment came out in 2018, and these, these are pretty sophisticated drugs. Your, your caller mentioned one of them which clearly didn't work for her mother, but they are all designed to block a neurotransmitter called cgrp, which almost certainly it definitely is an elevated, elevated levels when someone is having a headache. And the theory was that if we block this either from being expressed or from the receptor taking it up, we might be able to interrupt headaches. And for a lot of people, it has been incredibly life changing. Not everyone. In fact, one of the things I learned in the book is that if you hit, if a drug helps half the people, half the time, you're sort of on a. It's a winner, which to me is sort of striking because it, for a patient, it's essentially a coin toss. But it does for those for whom it does work. It's incredibly effective. Now, we haven't evolved beyond that yet. There are a lot of clinics and scientists who are now studying other possible neurotransmitters that we might be able to block, and they're sort of working their way through clinical trial now. So I wouldn't say necessarily that we've hit a wall, but the other way of looking at it is that it's taken us a long time, and probably too long, given the burden of these disorders, to really start taking them seriously scientific. So I feel the sense of frustration that your caller has.

[Alison Stewart]

How are you doing? What do you do when you get a headache?

[Tom Zeller]

Me? Yeah, I'm doing okay. One thing that does happen a lot with both migraineurs and cluster headache sufferers is that as they age, they frequently diminish. In women, it's often a hormonal thing, like it's almost. You can predict that once they go through menopause, many of them will see their, their headaches dissipate. And I think that the same is happening in men. There's changes in testosterone levels. There's changes in metabolism and so I am getting the headaches less frequently than I used to. It's actually been, I think a year and a half, two years maybe since I've had a cycle when they used to come twice a year. So I'm doing all right. When I get them, I take the CGRP injections and hope for the best.

[Caller]

The name of the book is the Headache the Science of a Most Confounding Affliction and a Search for Relief. It is by Tom Zeller. Tom, thank you for joining us and taking our listeners questions and calls.

[Tom Zeller]

It was really great Allison, thanks for having me on.

[J]

Our state has changed a lot in the last 140 years. We know because Multicare has been here guided by a single purpose making our communities healthier. That comes from making courageous decisions, partnering with local communities to grow programs and services, and expanding healthcare access to those who need it most. Together, we're building a healthier future. Learn [e-mail].

[Andrea]

Sometimes an identity threat is a ring of professional hackers, and sometimes it's an overworked accountant who forgot to encrypt their connection while sending bank details. I need a coffee and you need Lifelock because your info is an endless places. It only takes one mistake to expose you to identity theft. LifeLock monitors hundreds of millions of data points a second. If your identity is stolen, we'll fix it, guaranteed or your money back. Save up to 40% your first [e-mail] specialoffer terms apply.