Understanding Status Migrainosus with Intractable Migraine – Treatments, Symptoms & Causes

Status migrainosus has been associated with an almost 2 times risk for suicide above regular migraines. (Study)

Having a regular migraine by itself is enough of a pain, let alone when it lasts over 3 days and doesn’t respond to any medications.

Throughout the years I’ve successfully helped clients heal their migraines and headaches and in this article, I will be talking about 3 life-saving ways to understand what status migrainosus with intractable migraine is and what you can do about it.

Let’s start at the beginning.

What is a status migrainosus with intractable migraine? / Definition

Status migrainosus is described by the International Headache Society as a:

“Debilitating migraine attack lasting more than 72 hours.”

An intractable migraine is often described as being the same as status migrainosus but has a different meaning.

An intractable migraine is one that is:

Difficult to treat and does not to respond to standard and or aggressive treatment”

So status migrainosus with intractable migraine is:

A debilitating migraine attack lasting more than 72 hours that is difficult to treat and does not respond to treatment.

With / without aura

When an intractable status migraine comes with symptoms like visual blurring, zig-zagging, euphoria, depression, cravings etc. prior to the head pain phase, this is known as with aura.

When it comes without any prior warning in the aura or prodrome phase then this is without aura.

Symptoms of status migrainosus

Status migrainosus generally comes with the same symptoms as other types of migraine.

There are sometimes symptoms before the head pain in the prodrome or aura phase…

Followed by the attack phase that is known for its head pain…

And finishing off with the postdrome or more commonly known “hangover” phase.

Common symptoms of any of these phases include:

Migraine symptoms



Triggers and causes of status migrainosus and intractable migraines


Triggers of Status migrainosus can range from the simplest of things like lights, sounds or smells…

To really complicated issues that you need to have functional medicine testing for, like hormonal imbalances, gut dysbiosis, and toxicity.

It’s important to discover and understand both your triggers and causes.

Triggers are the actions, thoughts, feelings, and events that cause your trigger level to cross your threshold level and result in the trigger of a migraine.

Things like:

  • Foods(Inflammatory, sensitive or stimulating)

  • Food additives(MSG, sulfate, nitrate, histamine, tyramine, artificial sweeteners)

  • Beverages(High caffeine, high sugar, and alcoholic drinks)

  • Environmental changes(Weather, barometric pressure, temperature)

  • Sensory stimuli (Lights, noises, scents)

  • Medications (Rebound medication, stimulants, sedatives etc.)

  • Hormonal changes (Puberty, menses, menopause)

  • Physical activity (Overdoing, stretching, straining)

  • A stressful event

Causes are the series of stressors that put a load on your body and raise your trigger levels over time.

They can come from:

  • Mental Stress like work

  • Physical stress like over exercise or structural imbalances

  • Emotional stress like relationships or trauma

  • Nutritional deficiencies or excesses

  • Environmental stress like sick buildings, EMFs, poor quality air etc.

  • Lifestyle stress like a lack of movement, sunlight, poor breathing patterns etc.

  • Chemical stress

So causes are: all the factors that add to the trigger levels and triggers are: the pieces that just send our trigger levels over our threshold and cause our body to switch to the protective mechanism we call migraine.

It’s important to differentiate the two as some triggers will not show up until our causes have brought our trigger levels high enough to cause our body to react to and become sensitive to benign things like weather, scents, lights etc.

At which point the trigger sends us into a spiral and catches all the blame.

Most common treatments for status migrainosus with intractable migraine


This video will go into detail about what to do with a migraine that just won’t budge like intractable or status migraines.



Now let’s get into the good stuff.

How to understand status migrainosus

 Status Migrainosus Intractable Migraines

Before we get into the 3 lifesavers that studies have shown may reduce and even abort migraines, we need to understand what is going on and what we are trying to do.

So we understand trigger levels and our threshold along with triggers and causes.

And now we need to understand migraine.

The simplest and most beneficial way to understand migraine is as a protective mechanism created by the brain.

This study done by Dr. Borkum found that migraine is actually used as a way to increase the number of protective nutrients that are in the brain, so that the brain can stop the damage being done to it and help it repair from it.

This study actually talks about how we can use migraines to support neural regeneration which is the regeneration of our brain cells.

This is big and completely changes the way we look at migraines, for the better.

It means that migraines, like other types of chronic pain, are only a symptom of the damage that is going on.

This makes sense because, throughout evolution, our body has used pain as a reflex to protect us from danger like the heat of a fire.

What is causing the damage?

That is the million dollar question.

But there’s a problem with it because it is not that simple.

In the book, Heal Your Headaches, Dr. David Buccholz a neurologist and headache specialist actually says that migraines are a mechanism and that headaches may actually fall under the migraine mechanism.

Of course, a migraine and a headache are regarded as different but a cluster headache can be very similar to a migraine and cluster headaches have been known to turn into status migraines.

This is one of the reasons why diagnosis of all the different headache and migraine conditions can be so difficult…

In reality, as opposed to theory, all the symptoms blur together and there are no neat and clean lines.

The damage comes from a number of factors and these three life-saving ways will outline:

1. What some of the maintaining factors are to brain damage and pain triggers

2. How the brain is usually protecting itself from damage with nutrients and how migraine sufferers with nutrient deficiencies get more migraines

3. What nutrients to use and where to get them for brain health

3 Life-saving ways to understand what status migrainosus with intractable migraine is


Before we start it’s important to understand all of the above pieces.

See my video on status migrainosus and intractable migraines below.



But when we look at a source of pain that is not responding to treatment and lasts more than 72 hours, what are the first thoughts that come to your head?

Something is keeping the pain going


The body is not repairing quickly enough and doesn’t have what it needs to do so completely

And this is exactly what studies have found.

So let’s get into it and learn.

1. Maintaining Factors

Status migrainosus intractable migraines

First thing is first.

When there is a fire, stop throwing gasoline on it.

This takes some detective work and without proper functional medicine testing may take years to pinpoint but here are the main areas you need to look at.


  • Muscular and skeletal imbalances will continually pull on your body, shoulders, neck and head and can come from many, issues like posture, ergonomics, vertebrae out of place and seemingly unrelated issues like overloaded organs


  • We need to learn to tame the over thinking, overworking, over worrying monkey mind. It may have benefited us at some point and that is why we started using it but it is now a detriment to our health and we have to learn to calm the massive amount of strain it puts on our entire body from our breathing to our digestion to our hormones and adrenals.

My favourite ways to do so include:

  • Practising gratitude
  • Breathwork
  • Contemplation
  • Journalling


  • Emotions only last a few minutes when something happens, but when we hold on to them and cannot let them go, they will stay inside of us, charged for years. If this charge doesn’t get released, it will grow, bubble and boil inside of us, wrecking our bodies ability to cope. We have to find ways to vent and express our emotions, however our body needs it.


  • Food aggravations are one of the main causes of migraines. If we continue eating a food our body doesn’t tolerate, causes inflammation or is getting through our leaky gut and leaky brain… We can actually end up with food particles in our brain that are being attacked by immune cells and causing severe brain damage. Queue the migraines. But that is just one piece.

  • Our gut-brain axis controlled through our vagus nerve will send any danger signals from our gut, into our brain and this makes for hair-trigger migraines.

  • This was such an important topic that I had to write a book about it which you can find here.



Sick building syndrome is the epidemic of the 21st century and is a massive strain on our entire body and every system we have. From recycled air, to mold, to electromagnetic fog to fluorescent lighting to off-gassing of chemicals from construction, furniture and supplies and on and on… The environment you live, work and sleep is either supporting you or draining your resources. See our video on fluorescent light here.




Parasites are thought of as a third world problem but estimates are that around 90% of first world people have an active parasitic or fungal infection. These pests create lots of waste and by-products, many of which are neurotoxic like the ones from candida. They need to be screened for and the body needs to be supported enough to get rid of them. Itchy-foot, itchy scalp, itchy groin, they’re all likely infections.




The massive influx of poor dietary choices with empty carbohydrate and tans fast heavy foods, along with xeno-estrogens like BPA and heavy metals like those found in makeup products create huge hormonal imbalances. PMS is a relatively new problem and is connected to all of the rubbers and plastics we use in everyday life that are full of endocrine disruptors that send our hormones through loops. They need to be detoxified properly and the good hormones need to be fed right.



I screen all my clients and help them find fixes for common issues like breathing imbalances that cause or are created by bad posture, leading to neck breathing and often chronic headaches nobody else can fix. There is a huge number of lifestyle factors that need to be taken into account like water quality, circadian rhythms, quality light, movement patterns, ergonomics, hygiene and more.

It’s recommend to:

  • Get a full set of tests from a functional medicine practitioner or naturopath

  • Get a physical assessment from a NUCCA chiropractor, CHEK practitioner or osteopath

  • Have therapy and trauma release therapy if mental or emotional stress is involved

  • Get a holistic lifestyle coach or taking our 10 steps program

When we have stopped aggravating, then we can start supporting the areas of our reparative systems that are deficient.

If you need help, feel free to reach out to me here

Nutritional Deficiency

status migrainosus intractable migraines

Migraines have been found to be relieved and avoided through a huge number of nutritional methods.

One of the most effective ways to abort a migraine attack with 90%+ efficacy is IV magnesium.

Magnesium is just a simple mineral but is actually recommended in this study to be used in all migraine patients because half of all migraine sufferers may have a magnesium deficiency.

This is true for many different nutrients, but the amazing thing is that nutrient supplementation is so incredibly safe. Far safer than many migraine medications and this makes it a great way to go about healing stubborn migraines.

If our body is receiving the nutrients it needs to repair damage and prevent it from happening, it will be far less likely to have to trigger a migraine and go into protection mode.

Again, testing here is important and making sure your diet excels will give you much more benefit than just supplementing can.

So what are the most commonly deficient nutrients in migraine sufferers that may play a part in how they develop?

Magnesium (Study)

Magnesium is an amazing mineral and is warranted in most migraine cases because of its increasing deficiency in foods as well as amazing safety.

Some of the best ways to get magnesium is through:

– Magnesium flake and epsom salt baths

– Topical magnesium chloride spray

– Magnesium threonate, oxide, citrate and glycinate supplementation

– Magnesium rich foods (Dark chocolate, nuts, seeds, leafy greens, avocado, fatty fish)

See our video on magnesium here.

Vitamin D (Study)

Vitamin D is incredibly important because of the large deficiency of it in our culture. It is actually not a vitamin and should be renamed because it is a steroid hormone and affects every cell in our bodies.

Some of the best ways to get vitamin D are through:

  • Vitamin D3 supplementation

  • Direct, timed sunlight onto the skin

  • Foods such as (Fatty fish, liver, high quality eggs, pastured pork and some sun bathed mushrooms)

Vitamins B2-B3-B6-B9-B12 (Study) (Study) (Study) (Study)

The B vitamins are water soluble and any excess that gets eaten in that moment is urinated out. This means we need to get it regularly through our food or supplementation to meet our body’s needs but luckily they are available in many foods.

The supplements are generally known as a B complex but individual doses of higher amounts such as with riboflavin(B2) may be necessary.

Some migraine sufferers have genetic methylation issues so the B vitamins that are supplemented with need to be methylated like methyl-hydroxycobalamin(B12) and methyl-folate(B9).

The best food sources of B vitamins are:

  • Liver and kidneys

  • Clams

  • Sardines

  • Beef

  • Trout

  • Salmon

  • Non pasteurized and pastured whole milk

  • Eggs

Oxygen (Study)

Oxygen is used as a therapy to relieve tension, cluster and migraine headaches.

But what if it’s actually a deficiency caused by our breathing patterns, posture, organ health etc?

If we have bad posture, we can easily reduce our breathing by 30%.

If we have an inverted breathing pattern, which is common in many women because of cultures desire to have a flat stomach causing armouring around the diaphragm…

Then this will reduce the oxygen intake, lymphatic pumping and increase tension on the entire shoulder, neck and head complex.

Using simple breathing techniques and fixing our breathing mechanics can create a massive release of held up emotion and tension. See this article for more.

If you need breathing exercises go here.

Coenzyme Q10 (Study)

CoQ10 is amazing for its ability to cut headaches by 55% after 3 months of supplementation.

It is a massive antioxidant and can help protect our brain from damage caused by the most basic form of stress, oxidation.

It’s in many organ foods that our culture no longer eats, instead, opting for the muscle meats that have far less nutritional value.

Carnitine (Study)

Carnitine is an amino acid used in some migraine studies and is a by product of our body breaking down proteins.

It’s incredibly safe and easy to get through foods like:

  • Grass fed/finished Beef

  • Pastured Pork

  • Wild Fish

  • Insect fed Chicken

Alpha lipoic acid

Alpha lipoic acid is an antioxidant and helps prevent damage that can happen in the brain. Many foods have ALA but in low amounts so supplementation may be more effective.

When we are choosing nutritional supplements we have to remember that in nature everything comes in a nutrient complex.

Every nutrient comes with hundreds of other nutrients, bound together which all support the absorption and utilization by our bodies.

Every vitamin comes with minerals, enzymes, proteins, fats, carbohydrates co-factors etc.

So we want to make sure our diet is optimal and then supplement over and above an already solid diet.

Of course, what is most important, because of the varying causes for migraines is that the person’s total picture is taken in, testing is done across a few different areas and their specific issues are found because, in the body, everything reacts and supports everything else.

This is the basis for integrative medicine and the reason why so many therapies like nutrition, exercise, circadian rhythm synchronization, meditation and lifestyle therapy work so well for migraines.

And then there is using the science of nutrition to heal disease.

Nutritional Intervention

Status Migrainosus Intractable Migraines

In this study, through changing the diet of 60 migraine patients, 85% became migraine free and 100% improved.

This is no small thing.

Diet is a huge factor in both aggravating the brain and body, but also in healing it.

And it may actually play one of the largest roles in migraines, right up there with emotional stress.

So what are the best ways to use nutritional intervention for the migraines that just won’t end?

The hard answer is that we have to find all of the foods that are aggravating our bodies. This is often many processed, packaged, sugar-laden, additive-filled and over consumed foods.

Our bodies require lots of variety and whole foods… It evolved with them.

But luckily, the same whole foods that can help us steer clear of the bad ones, can give us the nutrients to heal our gut, brain, and pain.

The fastest way to do this is by starting a full elimination diet, going down to 2 or 3 definitely safe foods and then slowly working our way up and reintroducing/testing new foods every 2-3 days, eliminating those that cause aggravations anywhere in our body and keeping those that support us.

But this isn’t always doable for many people as its extremely strict so I’ve provided the resources below.

Some diets that work well for migraines depending on the cause are keto-genic, elimination, histamine and oligo-antigenic.

Our body has many signs that a food was wrong like brain fog, low energy, cravings, wired and tired feelings, burping, bloating, gas, loose stools, bad breath, mood swings etc.

We need to listen and learn from what it says. This is why I created the food triggers guide, the migraineur food pyramid, the 10 steps program and wrote these articles on what to do when you eat a clean diet but still have migraines, top 10 blood sugar stabilizing snacks and can a diet solve migraines?

When we can:

  • Stop the fire from getting gasoline thrown on it

  • Give our body the nutrients it’s missing that are starting the fires and preventing healing

  • Use nutrition to intervene

We can find ourselves much more successful in our healing approach and avoid long-term pain.

I have prepared a special webinar presentation which covers the WHY and WHAT to do about this constant brain pain and inflammation entitled The 3 Linchpin Areas That Destroy Hormones And Leave Your Brain In Pain. In this webinar I cover everything from why this is happening to what you can do about it as well as why these issues are rarely resolved properly.

To see the free webinar presentation click here.

Have you ever experienced a status migrainosus? What was your experience like and what did you do for it? Comment below.

Share this with someone else who is experiencing a hard time with migraines.

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The FREE 5 Most Common Mistakes Of Hormonal Migraines E-Guide teaches you:

– Why hormones are the most important focus around why your migraines and headaches keep triggering

– How PMS is common but NOT normal and why it needs to be addressed to be pain free in the long term

– The 5 most common mistakes why hormones stay broken, why so many women become migraine free with pregnancy and why birth control is not a solution