My slim friend has suffered with debilitating chronic migraines for years. Now, she's finally beaten them... thanks to Mounjaro. This is how: DR ELLIE CANNON

A friend of mine is often floored by chronic migraines. I don’t mean the occasional bad headache dispatched with a couple of paracetamol. They can leave her laid out for days, unable to work or function normally.Like millions of migraine sufferers, she has spent much of her life seeking specialist treatments – with varying degrees of success.So when we caught up last month, what she told me was fairly astonishing. ‘My neurologist has started me on Mounjaro,’ she said. ‘And my migraines have stopped.’I genuinely couldn’t believe it. I knew how much she’d suffered – and Mounjaro, of course, is the diabetes and weight-loss jab that has helped millions shed weight.My friend didn’t need to lose any weight at all. So why, I wondered, would her neurologist give her a weight-loss drug for migraines?The answer is fascinating. There are early signs that GLP-1 drugs – the family to which Mounjaro belongs – could reduce migraines in some, irrespective of weight loss. And as a sufferer myself, I wanted to know how. Because a migraine, as I know only too well, is not simply a bad headache.It is a neurological disorder. The classic symptom is an intense, often one-sided headache, accompanied by debilitating nausea or vomiting and extreme sensitivity to light and sound. An attack can last for up to three days.Around a third of sufferers also experience an ‘aura’ – neurological disturbances including changes to vision, difficulty speaking and pins and needles or numbness. Symptoms can be so dramatic that patients – and sometimes doctors – fear they are having a stroke. I genuinely couldn’t believe it. I knew how much she’d suffered – and Mounjaro, of course, is the diabetes and weight-loss jab that has helped millions shed weight, writes Dr EllieAnd the misery doesn’t necessarily end when the pain disappears, with sufferers left exhausted and struggling with brain fog for hours or even days. I’ve been lucky to work with a specialist who, years ago, taught me a simple but classic migraine trick – soluble aspirin.At the first sign of an attack, I take a high dose dissolved in a sugary drink. For me, it can stop it in its tracks – but others are not so fortunate. At the American Academy of Neurology’s annual meeting, experts presented evidence that GLP-1s may help. They analysed 20,000 sufferers, and found those on GLP-1s were less likely to need hospital treatment for migraines than those on the usual drugs.The benefit remained even when accounting for weight-related issues – so it could not be explained by heavier patients losing weight. It doesn’t prove Mounjaro treats migraine, but raises the possibility GLP-1 drugs are easing something which affects the condition.They appear to have anti-inflammatory effects, and inflammatory signalling is involved in migraines.But perhaps more intriguing is the gut – anyone who has severe migraines will know the stomach and brain go haywire together. The brain and digestive system communicate via nerves, hormones and chemical signals – and GLP-1 is one of the hormones involved.Mounjaro and other such drugs manipulate these signals, with researchers investigating whether changing this gut-brain link could also interrupt processes that trigger migraines. Their effects on blood sugar may be relevant too.So taking a weight-loss jab for a headache might not be as bizarre as it sounds. But Mounjaro is not licensed in the UK to treat migraines, and most neurologists are unlikely to prescribe it without much stronger evidence.So what can you do? I always urge patients to start by looking at their triggers. Even if avoiding them doesn’t eliminate migraines completely, it may reduce their frequency or severity. But before worrying about individual foods, it is worth getting the basics right.Poor sleep, stress, dehydration and skipping meals can all make someone more susceptible. Triggers include alcohol and caffeine. Some find foods containing tyramine – such as mature cheeses and cured meats – can provoke attacks.Bright or flickering lights and screen use can be problems, while some women may notice a hormonal pattern. Natural fluctuations in oestrogen – particularly around menstruation – are a well-known trigger, while hormonal medications can improve migraine in some but worsen it in others.Make lifestyle changes and help overcome high blood pressureHigh blood pressure is a major cause of heart attacks and affects one in three adults.And there is mounting evidence that some blood pressure tablets, including amlodipine, one of the most common, may cause kidney problems for those with type 2 diabetes.It sounds worrying but it’s vital patients don’t stop taking their pills. If you’re concerned, speak to your GP who can advise whether another medication might be more suitable. However, I also think we don’t talk enough about another approach that has few, if any, downsides: lifestyle changes.Over the years, I’ve seen many patients bring their blood pressure down to healthy levels by losing weight, cutting back on alcohol, improving their diet and exercising more.So have you avoided blood pressure medication, or come off it, after making changes to your diet or lifestyle? Write and let me know.Your questions answeredI'm 80 and have had an underactive thyroid for four decades. I take medication but still suffer from extreme fatigue and acid reflux. What should I do?Dr Ellie replies: It's possible that these symptoms might not be caused by the thyroid problem.The thyroid is a small gland at the front of the neck which produces thyroxine. This hormone controls how quickly processes in the body work, from the bowels and heart to the growth of skin and hair.When the thyroid is underactive, too little thyroxine is produced and these processes slow down. Classic symptoms include tiredness, constipation, weight gain, thinning hair and low mood, although the effects can be wide-ranging.But many other health problems can cause similar symptoms, so it is important not to assume the thyroid is responsible. Someone taking levothyroxine – the standard treatment – who continues to feel extremely tired or weak would normally have blood tests to check whether the thyroid is being properly controlled. If the results are abnormal, the dose may need to be adjusted.If thyroid tests are normal, another cause must be considered. Fatigue and weakness can occur with common problems such as anaemia, iron or vitamin B12 deficiency, as well as medication side effects and problems involving the heart, kidneys or liver.Acid reflux may be a separate issue. It can be caused by certain medications, a hiatus hernia or infection with the common stomach bacterium Helicobacter pylori, among other things.In someone aged 80, extreme or persistent fatigue should not simply be put down to a long-standing thyroid issue.Unexplained tiredness can occasionally be a sign of a more serious illness, including cancer, so a thorough GP assessment and blood tests are important.Do you have a question? Email DrEllie@mailonsunday.co.uk