In this episode, Dr. Kate Kresge welcomes back Dr. Asare Christian, a physical medicine and rehabilitation physician and founder of Aether Medicine, to explore why migraine is far more than "just a headache." Dr. Christian explains migraine as a sequence: a trigger sets off a neuronal process that activates the trigeminovascular system and, eventually, pain. He walks through common triggers (emotional stress, skipped meals, hormonal shifts, gut issues, poor sleep, toxins), the workup he runs, how CGRP-targeting medications and neuromodulation devices fit in, and why every patient with migraine deserves a personalized pain plan.
3 Key Takeaways
- Find the trigger before the pain. Dr. Christian has patients look back 48 hours before an attack to identify their personal pattern and "dial in" habits during high-risk windows like menstruation. (Goadsby 2017)
- Some nutraceuticals have real evidence. A 2025 review found riboflavin and magnesium can be recommended for migraine prevention, with CoQ10 supported at a lower evidence level; feverfew and butterbur call for caution due to limited safety data and hepatotoxicity concerns, respectively. (Tepper 2025)
- Look at the gut. Dr. Christian's most-ordered test for migraine is a microbiome assessment, and he shares a patient whose migraines resolved after H. pylori was treated. (Bawand 2023)
Guest: Dr. Asare Christian, MD, MPH, is a physical medicine and rehabilitation specialist and the founder of Aether Medicine in Wayne, Pennsylvania. His work focuses on identifying the root causes of chronic pain and migraine, including hormonal shifts, gut dysbiosis, inflammation, and energy deficits, and on personalized care that pairs conventional options with lifestyle, nutrition, and integrative therapies.
Clinical FAQ
What's in Dr. Christian's migraine workup?
Sex hormones, thyroid, a CMP, micronutrient testing (including intracellular levels when serum looks normal), microbiome and gut testing for dysbiosis, permeability, and infections, plus a look at environmental toxin exposure.
What is a pain plan?
A prepared, step-by-step response for when a migraine starts: how you talk about the pain, hydration, a calm environment, and which supplements, medications, or devices you'll use right away.
Which devices can help in the moment?
Dr. Christian discusses neuromodulation devices that target the trigeminal, occipital, or vagus nerves, which can be used for acute or preventive care without medication. (Ailani 2021)
Timestamps
– Introduction and episode overview
– Defining migraine and its global impact
– Conventional medications and CGRP antagonists
– Migraine physiology: triggers and the trigeminal system
– Hormones, diet, gut health, stress, and toxins
– Educating patients and building a pain plan
– The microbiome, pain, and inflammation
– Micronutrients, mitochondria, and energy
– Managing inflammation: supplements and LDN
– Herbs and mast cell stabilization
– Neuromodulation devices for migraine
– Key takeaways
Ready to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript helps clinicians bring supplement dispensing, lab ordering, and patient education into one centralized workflow. For more practitioner education on supplements, nutrition, and evidence-informed clinical care, visit Fullscript Academy at academy.fullscript.com.
Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.
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