Dr. Adam Harcourt Explains Why Migraine Treatments Fail After Head Injury | E41

If “migraine” meds aren’t touching your headaches after a concussion, you might be chasing the wrong problem. Dr. Wolf sits down with Dr. Adam Harcourt, a board-certified functional neurologist and fourth-generation chiropractor, to unpack why post-traumatic headaches so often get mislabeled as migraine—and how objective neuro exams flip the outcome. From eye movement control and gaze stabilization to neck proprioception and autonomic integrity, Dr. Harcourt explains the tests that reveal brainstem dysfunction you can actually measure rather than guess. 
 
You’ll hear a powerful case: a 10-year-old with “intractable migraine” that failed multiple hospital treatments until one overlooked detail surfaced—a basketball to the face the day before symptoms began. With targeted visual-vestibular and cervical work, her pain cleared within days and she returned to school and dance. That theme of foundations-first threads through the hour: build basic stability before intensity, or great rehab stalls. We share simple, surprising tools too—like rhythmic ear insufflation that can abort some migraines in minutes; sublingual ginger oil (Migraine Ginger Relief - MGR) that reduces reliance on triptans; and MQ7, a comprehensive migraine nutrient formula that streamlines evidence-based prevention without a cupboard full of bottles. 
 
We also tackle the big lifestyle levers without fluff. Caffeine: cutting down rarely helps; going to zero often does, because caffeine raises neuronal hyperexcitability. Diet: most people have sensitivities, not instant triggers, and a short, structured reset—including high-histamine foods—clarifies the few that matter. For medication overuse, we map a path out of rebound by lowering allostatic load and widening the “bucket” so weather swings, hormones, and daily stress don’t overflow into attacks. And if your symptoms look like vestibular migraine, hemiplegic migraine, or even “abdominal migraine,” you’ll learn how the same hyperexcitability model guides customized rehab for balance, facial motor, and lower brainstem pathways. 
 
If you’ve felt dismissed, bounced between triptans, Botox, and endless supplements, this conversation gives you a practical framework, specific tests to request, and at-home strategies to try now. Subscribe, share with someone stuck in the migraine maze, and leave a review to help more people find clear, evidence-informed care.

Dr. Adam Harcourt: Clinic Website

Instagram: @migrainedoctors

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Chapters

• 0:00 Cold Turkey On Caffeine
• 0:18 Welcome And Host Introduction
• 1:20 Meet Dr. Adam Harcourt
• 2:15 Why Migraine Diagnoses Miss The Mark
• 4:36 Objective Clues Beyond Symptoms
• 6:05 Hidden Concussions And Long Tails
• 8:39 Posture, Brainstem, And Neck Changes
• 9:59 The 10-Year-Old “Migraine” Case
• 13:18 Rebuilding Foundations Before Rehab
• 16:40 Home Tricks To Abort Migraine
• 20:41 Personalizing Care And Modalities
• 24:09 Nutraceuticals: MQ7 And Ginger MGR
• 28:21 Diet, Hormones, And Patterns
• 32:55 Caffeine: Zero Or Nothing
• 37:26 Histamine, Sensitivities, Not Triggers
• 41:32 Sorting Migraine From Post-Traumatic
• 45:25 Medication Overuse Headache Trap
• 50:33 Partnering With Conventional Neurology
• 53:19 Vestibular And Hemiplegic Migraine

Transcript

Dr. Adam Harcourt: 0:00

The decrease in caffeine from, let's say, 10 to 1, or 2 to 1, or 5 to 1, or 5 to 2, any decrease whatsoever doesn't make a difference. Doesn't really make a difference at all. But when you start looking at the change from having any amount of caffeine to zero, the change is huge.

Dr. Ayla Wolf: 0:18

Welcome to Life After Impact, the Concussion Recovery Podcast. I'm Dr. Ayla Wolf, and I will be hosting today's episode where we help you navigate the often confusing, frustrating, and overwhelming journey of concussion and brain injury recovery. This podcast is your go-to resource for actionable information, whether you're dealing with a recent concussion, struggling with post-concussion syndrome, or just feeling stuck in your healing process. In each episode, we dive deep into the symptoms, testing, treatments, and neurological insights that can help you move forward with clarity and confidence. We bring you leading experts in the world of brain health, functional neurology, and rehabilitation to share their wisdom and strategies. So if you're feeling lost, hopeless, or like no one understands what you're going through, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact. Dr. Adam Harcourt, welcome to Life After Impact. How are you? I'm great. Thanks for having me. Yeah, so you are a fourth generation chiropractor, a board-certified functional neurologist, and you have a clinic in Pennsylvania called the Harcourt Brain Center. Is that correct? Yep, that's right. Awesome. Well, I've had the honor of taking courses with you on migraines. You teach a 150-hour course called Mastering Migraine, which was life-changing for me and my practice and my patients. And I know you have people that fly from all over the world to see you to work. And so you're you're an expert in treating these very complicated headache patterns. And so I wanted to talk to you today about the, you know, kind of the patient that I see often, which is somebody who walks into my clinic, they've had a concussion or maybe multiple concussions, they're suffering from all different types of headaches and head pain. They've maybe tried a lot of different medications. I assume these are the patients that walk into your clinic as well.

Dr. Adam Harcourt: 2:18

Yeah, absolutely.

Dr. Ayla Wolf: 2:19

Yeah. So talk us through your kind of clinical process, your thought process, and working with these people.

Dr. Adam Harcourt: 2:25

Yeah, and uh, and I actually have a great example as of last week, just kind of randomly. Um, but we see these all the time, and and this is why I'm I'm so passionate about um kind of the teaching and and whatnot is I feel like when I first started getting into this, my education and understanding of these conditions was wildly off of what is actually happening. And it's also makes it really difficult to treat people, right? If you don't know what headache they're having, how are you supposed to treat them properly? And so um typically when people are coming in with post-concussion or what they think is migraine or whatever, there is a lot of overlap, which makes it challenging and there's not an objective criteria for either one. That's my big problem. Um, and so the most common thing you probably see as well is people come in and they've, you know, had head trauma or whatever, and they say, Well, you know, I've been diagnosed with migraine. They say, and you go through the list. Well, I've tried Topamax, I've tried risotript, insumatript, and immatrex, relpax, ubrelvi, amivig, jovi. And and I they list this whole list of things. And I go, Well, have any of them helped you? They go, No, not really. And and you're still trying these medications, like just for migraine. That's what they're for. And I say, Well, they said it was post-traumatic headache, but then when I had it for a long time, they said it was migraine. And I go, it just like hurts my soul because I'll see these people sometimes that have been in this situation for 10 years or 20 years or 30 years. And the changes you can make in a couple weeks, right, is life-changing. And it goes, well, what if we did this 30 years ago? Right. And so um, when I'm looking at what is going on with this patient, my first question is always history, right? Because if you're 40 years old and you've never had a migraine in your entire life, and you get in a car accident, now you have headaches, and they you get diagnosed with migraine, I can almost guarantee you it is not migraine, okay? Migraine is genetic, works differently than other headaches. Post-traumatic headache is not that, okay? The problem is it presents very similar, right? So if you have a subjective diagnosis and you have subjective symptoms that look similar to migraine, I mean, technically, the medical doctor, neurologist, whoever diagnoses you isn't wrong, right? They're using the gold standard criteria. But when it comes to actual treatment, then you don't get good results. And it's frustrating for everybody. And so what I found is we start with things that we can objectify, right? We look at things like blood pressure differences side to side. We look at oxygen levels side to side, we look at um things like palatal parasites and just ways that we can look at the system and say, hey, does this look like it is migraine or does this look like concussion? And I'll have a good example for you in just a second.

Dr. Ayla Wolf: 4:56

Okay. And so what you're describing with these exams is actually looking at a difference in, say, the sympathetic output or parasympathetic output from the brainstem, and is it different from the left side versus the right side? And that kind of gets into this idea of imbalances within the brain have these kind of both motor and autonomic output consequences that can actually be objectively measured.

Dr. Adam Harcourt: 5:21

Yeah. And it's really exciting because we're we're getting better at measuring these things. So for a perfect example is with post-concussion syndrome. You know, when when I was even starting school, the prevailing thought process was that only about 15% of people that get a concussion have long-term effects. And the reality was we just didn't know how to measure it, right? So that that was the best number we had. Now you look at research that comes out and we're going, oh crap, it's like 70, 80% of people that get concussion that end up having long-term consequences because we can see it. And I don't know about you, but this is a weird thing that I've seen commonly is people will get knocks to the head, whether it's car accidents, falls, things where, you know, again, 20, 30 years ago, you thought if you got a knock to the head and you didn't pass out, then it wasn't a concussion, right? So they think nothing of it. I recovered, I'm fine. But what happens is they got a concussion, there was damage to the brainstem or some area that is common with concussion. The brain was able to deal with the symptoms to where you felt like you were okay. And then in this like 15 to 17 year window, they start getting strange symptoms. And they'll they'll come and say, Yeah, I'm dizzy or I get lightheaded when I stand up or my headaches are coming out of nowhere, my neck's been really tight, or whatever. And you do an exam and you see all the same signs you see after concussion. You go, wait a minute, did you like, did you get in a car accident? No, no, not last couple of years. You go, what about like 15, 16 years ago? They'll go, oh yeah, you know, I was got hit, I got, you know, rear-ended sitting at a stoplight. It was fine, right? You go, maybe, like you didn't die, right? That's good. But there was trauma there. And because we didn't really pay attention to it, we didn't know how to measure it, people forever have just been told that they're okay. And, you know, again, yes, in the emergency, not going to die since that is true, but there was an injury. And so um, it's one of those things that we're seeing more commonly. And so I always recommend, you know, if you get any knock to the head, get an evaluation because if it's fine, it's fine. I've done that with many, many patients where I say, Oh, you're fine, go home, rest, you're good. But a good number of them, you do an exam, you go, oh my gosh, if you live with this for the next 10, 15 years, you're gonna be miserable and you won't know why. And so I always encourage people to just get checked out because we have better diagnostics these days than we ever have. And you're able to kind of nip this in the bud before it becomes a long-term problem.

Dr. Ayla Wolf: 7:31

Yeah, absolutely. Uh, yeah, I I can't remember when I was probably in my 30s when I had kind of my first x-ray of my neck, and they were like, Well, you have no cervical curvature anymore. And they're like, It's probably because of all your concussions. And so I think people don't recognize that even if they get a concussion and like you said, all their symptoms go away, there can still be these patterns in how your brain functions that then downstream causes a loss of extensor tone or a loss of certain firing down pathways that are meant to promote the proper tone and posture to maintain a cervical curvature and to do all these things that are kind of uh unconscious that we don't have to actively think about, but they can change over time when you hit your head.

Dr. Adam Harcourt: 8:13

Absolutely. Yep.

Dr. Ayla Wolf: 8:15

So uh you mentioned you have kind of a good case that just came in recently.

Dr. Adam Harcourt: 8:20

Yeah, so this kind of highlights what I talk about is we I had a case, young girl, and uh, you know, about 10 years old, and she came in because another patient had come in for migraine and uh was like, well, you know, go see them. And the reason they came in was because unfortunately, out of nowhere, she started having these intractable, miserable headaches, and she was in the hospital for two weeks, which I have a nine and a half year old, so I'm thinking, oh my goodness, this is I I can't imagine. And so they dealt another couple weeks with these headaches, and they said, Well, um, you have these migraines, and and I didn't find this out till later, but turns out they had three independent neurologists all diagnosed her with chronic contractable migraine. And so they said, Okay, well, here's all the medications we're gonna start. They could not break the headache um until they gave her a massive cocktail in the hospital intravenously, and that brought it down a little bit, and then it came right back. And so she's, I mean, she can't go to school. It's it's awful. So, luckily, this is why I say luckily, I end up seeing her about six weeks after this happens. And so she comes in for the exam, the mom's there, and real sweet little girl. And we're doing the exam. And and they said, Yeah, it's for migraine. And during the exam, I'm these eye movements are just rough. Now, in migraine, we're we see aberrancies commonly with things like convergence or I'm or pursuits and whatnot, but they're they're minor, right? They're they're not horrendous. This was to the point where I mean, she couldn't even follow a target if I was, I'm like, look at this thumb, please look at this thing, and could not do it. And, you know, her eyes, if you bring them in like that, they start going like this like crazy. I go, what the heck is going on? And so I just kind of mentioned to our mom, I go, you know what, this this doesn't really look like migraine. It looks like she had a concussion. And the mom kind of looks at me sideways and is like, okay. And uh we keep doing the exam and what we're finishing up, I go, yeah, this looks like concussion. I said, well, you know, it's possible it's migraine. She's young, you know, we'll see. But I said, and I just off-handed, I go, you know what's interesting is I found a number of patients where I tell them I think they have a concussion and they swear up and down they didn't have it. And then later on we found out they did. It's not because they were hiding it from me, it's because they got hit so stinking hard, they forgot that it happened. And I'm telling this to the mom, and the little girl looks up and she goes, Oh, she's like, Mom, I got hit really hard in the face with a basketball. And the mom looks down, she goes, What? And she goes, Well, when did this happen? You never told us this. She goes, Um, the day before I started having headaches. And and the mom's like, What? And so I start going through it and I say, Well, you know, she's probably gonna have trouble in the car. She might have trouble in like grocery stores or crowds. Mom's like, oh my gosh, that's exactly what's been going on. And she goes, This makes so much more sense because they tried tryptins and other things, none of it was touching it. I go, well, tryptins are specific for migraine, they don't work with post-traumatic. And they go, Oh my gosh. And so we got her in, we we treated her when within like two days uh of treatment, no headache. And I just saw her yesterday. Um, she's been fine ever since, back in dance class and school, and um, she's great, she's fine. And the reason I was so excited about that case is I typically see that little girl 20 years in the future, right? Didn't go to college, having trouble at work, on 15 different medications, no idea what's going on. And we end up doing the same type of thing for that person when they're 30. And it's great because we help them out, but that was 20 years that they didn't know what to do. And so that was a uh for me, it was a really exciting case, just because it kind of puts into perspective all the things that we keep trying to teach, like, hey guys, if you're not getting this success, if if people keep telling you, hey, it's migraine, but every migraine medication doesn't even touch it, you gotta look for something else. Okay. And um, so this is this is one where, you know, the mommy would say, she's like, well, what the heck's going on? You know, these neurologists, they they all said it was migraine. I go, technically, they're all right, right? Because by the diagnostic criteria, she had the intensity, she had the light sensitivity and sound sensitivity, she had the things that meet the gold standard diagnostic criteria. They're not wrong, right? The way we diagnose it, they're not wrong. But again, this is why I emphasize in in teaching and everything how we have to look at migraine completely differently than than it's currently looked at, because it's wrong. It's just not, it's not a good way to diagnose these conditions. And if you can differentiate between the two, now these people get better wildly quicker.

Dr. Ayla Wolf: 12:33

And can you talk a little bit? I know that you use a lot of different therapies. You practice functional neurology, and so you're creating individualized treatment programs for everybody that comes in. Uh, in this individual case, were there certain things that you felt really made the difference for her within just those two days where she had this really quick recovery?

Dr. Adam Harcourt: 12:52

Yeah, um, so there's a few things. The one big one, and this is actually, well, you're one of the first ones to hear about this, is we're in the process of doing a new research paper looking into certain eye movements and the correlation with migraine, because I see it so commonly. And so there's certain movements that if I see that they're off, I'm like, oh my goodness, that's that's probably a bad migraine. And sure enough, they're the ones that have 20 or 30. So we're gonna actually look into this a little bit more closely so we can, because a lot of what we do, there's evidence in the literature that this kind of thing could be helpful for migraine, but there's no indication why or when or how you do the therapy or what the background is. So we're kind of gonna start from the ground up and say, okay, here's the problem we're seeing. And then once we see that problem, we can quantify it. Now we're gonna do therapy for it, the way you and I do, and then show the outcomes and show that this gets better. And it helps bring it back to the fact that this is not a blood constriction problem or dilation problem. It's not, you know, anything else that we used to think. It's a hyperexcitability problem in the brain, and we can make that more stable through treatments. And so um, in her case uh specifically, we saw big issues with um what are known as uh so gaze stabilization, so big gaze stabilization problems. She could not keep her eyes on a target to save her life. Um so we had to do really we had to modify those a few times where she couldn't look at a target because she would keep looking away from it. She couldn't keep her eyes on. So we had to modify that. Um and then we also found really interestingly, I thought it was more the eyes that were the problem. But then when we started looking at neck proprioceptive activity and had her moving back and forth, we found that that was really challenging and started to flare up quite a bit. And so I think what happened is when she got hit, she got extension of some of these neck muscles. And that proprioceptive change made a big difference in the way the eyes were moving. So we did a combination of basically having her look at a target with, you know, a head laser so she's focused on a target, and then we would rotate her. And what was really interesting is when she went one direction, she did really good. And then when she went the other direction, the head kind of goes with it and it can't stay still. You go, what the heck is going on? And what what's interesting is you think about that stuff, you know, as a patient or somebody that's not familiar with this, you go, who cares, right? That what's the big deal? But then you think about it, wait, the way our muscles are controlled, the way our eyes are controlled, are all unconscious and they're just supposed to work. Now imagine if you're turning to look at your computer or you're driving or you're seeing all this stuff and you're constantly processing this information, but you're not doing it properly. That is exhausting when you do it throughout the day. And it gets to the point where the brain just goes, I can't do this anymore, and it shuts down, right? It locks the neck muscles, it makes you headache, dizzy, and it basically gives you symptoms to say, hey, quit moving around. We don't know what's going on right now. And so when you fix these very simple, basic things, which are not simple and basic to fix, but simple, basic ideas, and they get better. Now you've laid the foundation for the rest of the nervous system to function properly. And so that's how I kind of look at my treatment approach is if there's very basic stuff that's not working, I could care less about everything else. I hammer that until it's better, right? I just I want the basics to be good. Once they're better, then we can do more interesting stuff. I had her up dancing by Friday and she's doing all these different movements, and you know, I have her doing D2, which is like that lightboard exercise, and she's having a good time. But if you start there because that's the end goal, but you don't fix the foundation, these these people go through, I may just had one that went through rehab for three years with zero change whatsoever, because again, they're working on things that the foundation can't handle. So I think that's a really important point.

Dr. Ayla Wolf: 16:25

It is. The uh the the kind of order of operations of how to kind of rebuild a nervous system is is key. And uh I see that all the time too, that people um are maybe doing great therapies, but they were just the wrong therapy at the wrong time.

Dr. Adam Harcourt: 16:40

Exactly. I I always liken it to like, you know, if you had a twisted ankle and the goal was to run 10 miles, so your first therapy was to run 10 miles, that ankle's probably not getting better, right? It's not a bad therapy, it's not quite there yet, you know? And uh it's also like if you get the ankle to where you can put some weight on it and you can take two or three steps, it's like that's great, we're making progress. But if you go out and run two miles, it's probably gonna hurt, right? And so that's another tough thing with recovering from this, is you can't see the area in the brain or brainstem that's damaged, so it doesn't feel like an ankle or a broken bone. But it's the same problem. And so a lot of times you'll get people that have concussion that let's say they have really bad headaches or really bad dizziness, and you get them somewhat stable to where they're not having that all the time. That's great. But the first time they do something that overstimulates the system, they have them come back, they go, Oh, I thought I was better and now I'm not. It's like, no, you're you're just taking five or six steps right now. You're you're not to the three miles yet. And that's okay. Um, and everybody does it. It's not unusual, it's a very common thing. Um, it's just it's really tough for us to process because once you feel better, you kind of feel like you've you're always gonna feel better. Um, and that's just kind of not how recovery works.

Dr. Ayla Wolf: 17:50

Right. We want it to be very linear and upwards, but 100%. It's not that way.

Dr. Adam Harcourt: 17:55

We do too. I I want the same thing. It's just unfortunately not how it works.

Dr. Ayla Wolf: 17:58

Yeah, yeah. Now, there was something that uh you had taught in the courses that that I took from you, and it was a little kind of like sensory trick to help abort a migraine, which is where you take an insulation bulb and you just do a puff of air into the ear like once every three seconds for 90 seconds. I have used that with like absolute great phenomenal success in my practice.

Dr. Adam Harcourt: 18:23

Oh, isn't it? Yeah.

Dr. Ayla Wolf: 18:24

Yeah. So can you talk about that? Because most of my patients are like, what are you about to do and why is this working? And then I do it, and then within 10 minutes, they're like, oh my gosh, my migraine's gone.

Dr. Adam Harcourt: 18:34

It's the craziest thing. And I'll give credit to another neurodoc that actually published the first paper on this, Dr. Dave Sullivan. Um, he's the one that kind of discovered this, if you will. And he published a simple paper. He said, you know what? We take this insufflator bulb, um, we pump it into the ear, and we see migraines go down. I go, that's interesting. And so I started using it and I found a couple, a couple nuances to it. And one is um you can't just puff air into the ear, it has to actually deflect the tympanic membrane. I don't find that it works very well if you don't do that. Um, the other thing is with the stimulation, the reason it works, we think, again, this is somewhat experimental, is there's about three different cranial nerves that are all innervated into that tympanic membrane, and they relate to migraine, right? Trigeminal being one of them, vagal being another. And so what we think happens is it's a neuromodulatory effect, just like peripheral nerve stimulation, just like laser, just like anything else. And what they they found is if you do the insufflation, and you can do it differently. So a lot of times I'll start at maybe 30 seconds, do like two hertz, right? Pump it once or twice a second, and then I'll go longer, shorter, depending on how they respond. But what he showed in his paper is if you do about five rounds of that and they don't really get much better, they're probably not going to get better, right? But if they're improving after five, they can keep improving up to about eight or nine rounds of that, you know, 30, 40 seconds. The other thing that I found personally is that if they've already taken like a tryptin, like a rescue med, doesn't tend to work as well. It can. I've had one or two where they get responses, but usually if they say, Yeah, I got a migraine, I took my Imatrex, and then I came in, that's fine. It's just probably not gonna work as well. So um, I use this as kind of part of my armamentarium to knock out a migraine, but it's one of the first things that we start with because it's non-invasive. It usually doesn't bother people. Some people have an issue with it, but most people feel okay. Um and it's like, well, the worst case scenario is it doesn't help, right? But best case scenario is you take your eight or nine out of ten migraine down to like a three. You don't have to take mes, no rebound effects. It's a pretty, pretty cool and interesting uh modality. And um I again, I I don't know the specifics, but I believe there's some people in our group that are working on more of an automated version of it where you could just put it in the ears, set it to whatever you want, and then it could either be an at-home unit or one you can use in your office. Um, so there's some cool stuff coming down that'll make this a little bit more uh kind of accessible and tangible for people.

Dr. Ayla Wolf: 22:11

Yeah, I really like it because usually I can knock that headache, like you said, down uh from an eight out of 10. Then all of a sudden you said, like you said, it's oh, you know, like they're like instead of this throbbing pain, maybe I now just feel like a little bit of a dull pressure. And so then obviously, once you've knocked their pain down a few notches, then it's easier for them to do the other therapies afterwards uh to help, like you said, help stabilize a hyper excitable brain, essentially.

Dr. Adam Harcourt: 22:37

Yep. Yeah, and that's that that that hyper excitable, that's the cool part about what we do is the the only way to fix this is either through fixing the genes, which we don't know how to do, or creating protein, because protein's negative. And that's the cool thing about these therapies is it might be good for them, but if you do too much, they get migraines. Okay. And if you do less, then it doesn't, it's not enough to make a change. And so, like you said, part of our part of the difficulty in the early stages is finding that sweet spot where you're pushing it enough to make that protein production, but not too much to push them over the edge. So I always have that conversation with people because um, you know, very a lot of them have, you know, got adjusted and then they get a migraine. They go, oh, chiropractic's terrible for my migraine. I go, that's great. They go, what? I said, no, no, no, not because you get a migraine. I said, that means that pathway is directly involved in your migraine. There's just too much stimulation, right? And so we have protocols to fix that. So it's an exciting thing because there's no one perfect way to fix this stuff. And each person with a migraine has different areas that are involved. So you might benefit more from acupuncture for patient one, but then from massage from patient two. And so that's what's exciting, I think, about the model is it doesn't say here is the treatment. If that doesn't work, good luck. It says, well, we have a good idea of what we're gonna treat with you, but that's gonna change based on how you respond, and we can adjust from there. So I think I think it's just an exciting way to go about these cases.

Dr. Ayla Wolf: 23:56

Yeah, absolutely. And I have some people that can handle acupuncture very well. I have other people that uh they'll come in and they'll say, you know, anytime I get acupuncture anywhere on my head, it triggers a migraine. And I'm like, okay, cool to know. We're not gonna do that.

Dr. Adam Harcourt: 24:10

Exactly. Well, and that's the thing, is it that's what I love, is it's not because you know, in the courses, we we have chiropractors, acupuncturists, PTs, massage therapists, uh, DOs, MDs, like everybody has different backgrounds. And so the point isn't you have to do this one thing. The point is let's zoom out and understand migraine. And from there, if you have all the modalities to address it, hallelujah. But if not, you take care of what you can take care of and then send them to somebody else that um takes care of something else that you know that they need. And it just, it's my big problem with um kind of primary care for migraine is is nobody treats it like that. Everybody treats it for what they do and not for what migraine is, and that's why people tend to bounce around so much. And it's just it's a really frustrating cycle.

Dr. Ayla Wolf: 24:51

Yeah. And then you're uh you're involved with a company called Biogenic Nutrition, and they make a very interesting product, which is a ginger migraine abortive product. And I love that as an option for people because a lot of my patients, they are really trying to limit the amount of, say, sumatryptin or those tryptin abortives that they have. And so to give people an option that's more natural, if it works for them, awesome. So, are how often are you using that ginger in your practice?

Dr. Adam Harcourt: 25:21

Yeah, so we use it for every migraine patient. Um, not because it works for every patient, but because if it doesn't, no problem, right? It's not like you're given a bunch of meds. But if it does, what we find is then they can kind of come off of their tryptins and you have a lot less rebound headaches and hangover headaches. And that was interesting because I helped formulate that as well as MQ7. And the reason was the program, the migraine program. When I was going through this, I we had our you know, three days where we just talk about nutrition and hormones. And I'm going through all these supplements. I go, oh my goodness. I looked them up, and to have all of those on a monthly basis was like over 200 and some bucks a month. I go, this is ridiculous. So I didn't know these guys. I called them up and said, hey guys, I'm doing this program. I they had some other products I liked. I said, is there any way you could just make something that has all this stuff in it? Would that be okay? And they were like, yeah, nobody's ever asked us that before, but sure. And so it took them like a year and they they were able to put together the MQ7, which essentially has all of the vitamins, minerals, nutrients, you know, anything that's been shown in literature to help with migraine in the right dosages and right combinations. So we started using that back when the program started, and it's been fantastic for prevention. Again, not because it prevents all migraine, but if supplements are gonna help, that's gonna do it. It's wildly more affordable than if you were to get all the stuff individually. And so I have people start with that because if that helps out, then we don't need to take other supplements, right? We're done. And if it doesn't, well, we don't keep trying a million different things because sure, there is a possibility that other stuff could help with individual patients. But at that point, you know, you have a million different, you know, options. And so then there was a study back in 2013 where they were giving people uh ginger capsules and it was helping with migraine. And the cool thing was it was equivalent to sumatryptin as far as what patients felt like they they got benefit from. And so I started doing that, and I liked it because we would give them ginger capsules and it would help. But because it had to go through the GI tract, it took like two, three hours to work. So I asked the guys at Biogenic again, hey, could you make this sublingual? And they go, sure. And so it's literally just MCT oil and high dose ginger. That's that's what it is. But because it's sublingual, it gets into the system within 15, 20 minutes. And what I found personally is if you've responded well to tryptins in the past, you'll probably do well with the MGR. The other important point is a lot of people confuse their different headaches for migraine. So they might get servagogenic where it hurts back here 10 days a month, and then two days a month it goes into the eye. Well, what they're telling you is they have 10 servagogenic headaches and two migraines. And so what I tell them is I say, hey, these headaches back here, MGR is not gonna help. But if it's up here, there's a good chance that uh it's gonna work for you. And so, you know, full disclosure, I had nothing to do with the company up until recently. And so they actually asked me to come on to help create content and um talk more about migraines. So I am working with them now, but I've been using it for six years. And it's just such an easy, simple thing to add into their care instead of trying to, you know, take 50 different things a day. Um, so it's been it's been a really neat thing. And I think looking at the literature, there's some new stuff coming out. And as new things come out, I want to actually incorporate that into the product. And that's kind of the goal long term is to keep up with the literature.

Dr. Ayla Wolf: 28:38

Awesome. And I find too that a lot of people are out there searching for answers on the internet by themselves, and then they they hear, oh, well, this supplement is supposed to help, and that supplement is supposed to help, and then they start ordering things off Amazon and you don't know what the quality is, and then all of a sudden you got a cupboard full of 20 bottles and you forget kind of why you're taking what. And so the fact that the MQ7 takes all of the kind of evidence-based uh vitamins, minerals, herbs, and puts it all together in one bottle is like very nice for people.

Dr. Adam Harcourt: 29:09

It's so simple. I I know. I I actually got kind of overwhelmed when I was teaching the program. I'm like, how are people gonna take all this stuff every day? And um, it just makes it simple. And now that that's also what uh it's also kind of the basis of what I do for hormone treatment, which we probably won't get into that too much. But um, the only time that I'll really give other stuff then is if we do actual testing and we find out, yeah, actually we need to, you know, add this or add that for you personally, but we don't know that till testing. And so I feel like that's the best way to do it is here's the blanket. This helps kind of a bunch of people no matter what. And then for you personally, let's do some individualized testing. And if you need other, you know, vitamin supplements, hormones, whatever, then we can address that like for each individual person.

Dr. Ayla Wolf: 29:49

Yeah, yeah. Well, and I find too that sometimes when you've got somebody with really severe migraines that are having migraines like 20 days out of a month, a lot of times for women, as they get better and as their brain stabilizes, then all of a sudden it becomes much more obvious that the migraines are now coming on hormonally during the cycle.

Dr. Adam Harcourt: 30:08

Yeah.

Dr. Ayla Wolf: 30:08

It's like, okay, now let's dive into those hormones and figure out that piece.

Dr. Adam Harcourt: 30:12

Yeah. And I always tell people if if somebody comes to me and they're having 30 a month and I get them down to two, I can guarantee those two are going to be right before their cycle starts, every time. And so what I've what I used to do was run the hormone test right away. But then I was finding a lot of that was inflammatory, and the diet was taking care of it anyway. So what we do is we do dietary stuff first for like a month or so. And then if they're, you know, getting better and they still have those hormone issues, then we do the hormone test because at that point they've been on the diet, they're anti-inflammatory, all that. And if they still have abnormalities in in the the uh hormones, we know that that's a problem we have to address. And that's where, you know, every month we see it get a little bit better, a little bit better. And that that's a goal of care. I don't expect it to go away like that. It's not how it works. But as long as we see a decrease in frequency, intensity, or duration month to month, we know we're doing doing the right thing.

Dr. Ayla Wolf: 31:01

Yeah, yeah, absolutely. And in terms of the diet, since you brought that up, uh, are there are there certain like things that you feel like are the biggest? offenders that you absolutely say to people, like, let's cut this out. Our favorite beverage.

Dr. Adam Harcourt: 31:16

I I'm offending right now. Well, and it's the worst the worst thing is like, um, because I I don't get migraine, but I love coffee. And you know, it's something that I I have all of my migraine patients off of. And so if I make the big mistake of having coffee out in the thing, I I get heck from all of my patients. What are you doing to me? You got me off of it. Come on. So real quick about caffeine and because there's a bunch of arguments. And what irritates me about literature actually is if you look at each individual paper, there's one that says no, it doesn't make a difference. And then oh it makes a huge difference and no it doesn't actually make a difference. But if you just look at all of the literature in an aggregate and what their conclusions are, what they actually find, not just what they think they found, what you notice is that the decrease in caffeine from let's say 10 to 1 or 2 to 1 or 5 to 1 or 5 to 2, any decrease whatsoever doesn't make a difference. Doesn't really make a difference at all. But when you start looking at the change from having any amount of caffeine to zero, the change is huge. Right? And what they found is that caffeine itself does a couple different things. You know, it is a drug so it changes your brain conformation specifically it changes like CSF production and things like that. But more importantly related to migraine there's studies that directly say caffeine directly increases neuronal hyperecitability. What are we trying to do with migraine? Decreased focal excited hyperexcitability, right? So it just makes sense across the board that it's likely to contribute. And so my spiel is always the same with every patient because I've done this with thousands at this point. And I say look we're going to get off this caffeine for a few weeks okay if you have withdrawal it's all the same. It's a bell curve, right? And so what happens is day one, you're kind of tired but you're okay. Days two and three, if you're going to have withdrawal, that's usually when you have fatigue, headaches, all the miserable stuff where most people are like, this is worse than being on caffeine like I'm just I'm going back on, right? But if you can get over that hump, then everything levels out and you get better. So let's say we're doing our treatments, you're off caffeine, you're doing good stuff, and you get to a point where you're like, man, I'm I'm doing a lot better. I was having 20, I'm down to one a month, the MGR takes care of it. This is great. If you then try the caffeine again and you start getting migraines, I don't have to tell you to stop, right? You know what's going on there. But conversely, I do have a small number of patients, I'd say 10 to 15%, that go back on caffeine, they're feeling great and they have no problems. Well I don't care. Like I'm not anti-caffeine right it's not like I just don't like it. It's just I don't want it to cause your migraines. And so if you go back on and it's fine, well, hallelujah good for you. That's that's fantastic. But that's why we only have the conversation one time. And after that it's like either you know it's not good for you and you just stay away or it doesn't bother you and you're fine. Right? We just want to make sure we cover our bases because when it comes to migraine there's so many little things that can create a problem. I just want to make sure that we're we're being comprehensive because I I've had cases where you know everything should be good and it turns out pineapple was the thing that was driving their migraines. You're like who would have guessed sinking pineapple and so we have all these things that sound kind of silly but it's because I've had one or two or three cases where they just did not go the way I expected and I'm so confused and it ends up being something silly like that. So I always tell people I'm very mean for the first couple weeks and then I get a lot nicer as you feel yep got it.

Dr. Ayla Wolf: 34:34

And I guess that brings up the the histamine conversation too like some people are very sensitive to histamine production certain foods that are higher in histamine so how um how much attention are you placing on that?

Dr. Adam Harcourt: 34:45

A lot. Yeah I actually it's funny I had a patient yesterday where I was going through this stuff and they're like that's we're really weird because like every food I would point out in the histamine they go wait I have an allergy to that I'm sensitive to that I'm I have an issue there. And it was literally every histamine food I said well I I think we know what what the problem is there. But most people don't have that reaction because the big problem with migraine diet is most people are looking for what what you would consider triggers right so I took gluten out it didn't really help my headaches. I took dairy out didn't help my headaches. Well I found in my experience almost zero people have triggers right not zero it's like three percent maybe almost everybody though has sensitivities meaning that if you are sensitive let's say to gluten and dairy and tomatoes and pineapples right well none of them are driving or causing migraines as soon as you take them but what they do is they are inflammatory to you. So if you take out gluten for example but you're still eating dairy and tomatoes and whatnot, you're still getting the inflammation so you don't notice a change so you go oh it wasn't gluten. Then you go off with dairy right same experience. So what I found is if we get off all the things that can cause a problem including histamine so that includes you know things like your nuts, your eggs, pineapples, papayas, tomatoes, those types of things when you get off of everything, see how you're feeling when you add them back in what typically happens is I didn't get a migraine but you know what I got really congested or I got really tired or my stomach felt weird or something that just says this isn't inflammatory food. And then you end up finding about three or four of these, you go, holy cow, I eat these things every day. And so once you know what they are, it doesn't mean you can't have them again. It just means okay I'm not gonna have a pineapple pizza every day, right? Because for me all those foods are a problem. So if you're gonna eat them, you know, do it every once in a while try not to eat them together. But also I just find the control of knowing that is so just relaxing to migraine patients. So then if they do go have a pineapple pizza and they have three glasses of red wine and they wake up the next day with a migraine, they're like, yeah, it sucks, but I I know why that happened and it's not as stressful. And I I found that that control is is really really important for long-term compliance because nobody wants to be on a super strict diet their whole life. But if we can say well I went on this diet now I know there's a couple things that kind of flare me up now then now it's your decision, right? Just like if I want to go out and have five beers tonight, you know, might be my decision, might have fun, but I'm probably not going to feel great tomorrow, right? That's that's okay.

Dr. Ayla Wolf: 37:12

Yeah. And then I find too like people do when people are experiencing true migraines, they do usually come in and they'll tell me these are the certain foods I need to avoid. Whereas when I have people with post-traumatic headaches or they're not coming in saying oh when I eat this food I get a headache. They're you know and so I think those little clues just in people's in you know intake too can kind of guide you and to be like, okay, you know, does this look more like a real migraine or are we dealing more with a post-traumatic headache?

Dr. Adam Harcourt: 37:42

For sure. Yeah and I have a couple basic questions I always ask I always say where exactly is the headache located? Okay, that's my my number one. Then I always just ask their history of medication use, right? What helped them, what didn't because can you have migraine and try to work for you? Sure. But normally the reason that that happens is each tryptin works on different serotonin receptors. And so if they've tried three or four and none of them have worked, now it's less likely to be migraine. Still not impossible. But if they say well none of the tryptins have worked when I say migraine it's top of the forehead or it's back of the neck or it's on the sides well those two things combined right there tell me that's probably not migraine, right? And then if they say well I got it and it started right after a head injury and I never had a history before probably not migraine right um and then they'll say well I, you know, I actually can't be migraine because I don't get any of those auras, the visual stuff. Well only about 33% of people with migraine have aura right so most people don't uh so there's just there's all these little clues that I kind of walk through and then when I'm doing the exam, for example the the differences in blood pressure and all that, they're usually pretty subtle with migraine where they can be a lot more accentuated with post-traumatic headache. And just as you talked about the importance of like diet nutrition and hormones huge in migraine not as not I don't want to say not important. It's just not as many people have that as a big problem. So like 98% of my migraine patients there's a hormone nutrition component. I'd say like 40 or 50% of post-traumatic headache that actually ends up playing a part. So it it that's a case by case basis um which is why I don't I don't kind of emphasize it as much. I typically go right in for the neurotreatment on those cases, get them treated right away and then if they need more we do diet and hormones. Whereas if you have migraine I'm making you do the diet and hormone testing all that before I even see you if you're coming from out of town. So that way we know all of that is dialed in. So when I see you for the the neurological treatment we know that any changes are due to the care and not from withdrawal from caffeine or blood sugar issues or those types of things.

Dr. Ayla Wolf: 39:45

Yeah. And how often are you seeing people who you think are actually suffering from medication overuse headaches?

Dr. Adam Harcourt: 39:51

Yeah so this is this is interesting is they used to put migraine kind of way down there in the disability you know kind of scale and it wasn't until a few years ago where they go, wait a minute, in the medication overuse category like 99% of those are from people that have migraine. And so once they combine those two, they found wow, migraine is the second leading cause of disability worldwide period. And in people under 50 it's the leading cause which is just wild. And so the reason that if you take tryptins they say no more than about nine or 10 a month is because once you get past that your brain gets used to that kind of you know flood of serotonin receptors being being activated or it um or the agonist to them and they get used to it. And so now it's really really hard to not have a headache because you're basically having withdrawal from the medications which increases your stress levels which increases your probability of migraine so you take another medication and it's just like this snowball effect. It's awful. So that's why the first thing I do is get them on MQ7 and MGR because even if I can take them from 15 or 20 tryptins a month, which again they're not supposed to do, but people got to get through if I can get them down to taking like five a month, that already starts to reverse this process right away. And so that we we try to do everything we can to kind of lessen the load and that helps them get off the medication overuse headache because that that it's like a drug withdraw. It is a drug withdrawal it's like a caffeine withdrawal it's just it's really really rough but if you can get them over that hump they do wildly better.

Dr. Ayla Wolf: 41:18

Yeah and I find too like some people will take their tryptins uh as prescribed meaning they might only take them nine or 10 days out of the month but then they're taking ibuprofen or you know Advil every other day of the month and it's like okay well that's also a problem too.

Dr. Adam Harcourt: 41:33

Yeah doing what you got to do. And that's why I tell people is that well you know I tried Botox but I didn't want to I don't I'm on this medication. It's like well if you didn't have any other options I mean what do you do? You got to get through life right and so when we talk about what what to take when you have a migraine I never say there's a good or bad thing to take I just say look there there's kind of a hierarchy of stress levels or what we call allostatic load to the system. So if we can just lay down, take some MGR and put some ice on the front of your neck and you feel better, hallelujah, right? That's great. But if that doesn't work and you end up having to take a tryptin and that gets rid of it, well that's what they're for right so you just want to use these things as needed. When you haven't been given any other options and this is basically all that you have to do, well then that's all you have to do. And so that's how people tend to get in this medication overuse kind of spiral. And that's why again I I'm like we try to get out and talk to as many people as we can. I just did a grand rounds down at uh Johns Hopkins and we we had a great conversation with the doctors there because they're in this same kind of boat. They're like look we go by the objective diagnostic criteria that's given to us and based on that then we follow the protocols that are laid out for these conditions. And in that scenario a lot of people fall into migraine and then the sequence is you know you take the topamax or you take the you know risotriptins or you take the uh whatever it is, the the Mgalides, Jovies. And that's kind of the model. And they're doing the best they can but you also have to realize with medical neurology they're also dealing with life-threatening conditions, genetic disorders, rare conditions, things that just take a wild amount of time to keep people from dying from like that's that's really what they're doing. So when you end up with migraine, it's like yeah it's miserable but you're gonna be okay meaning this person's not going to die. My other one over here might so I'm gonna put all my effort into keeping that person from dying. And so our my I feel like our responsibility is to say, okay, that that's great. We need to start putting out a lot more literature and education to say thank you for ruling out the tumors and strokes and all the stuff that could be causing terrible things. Now our expertise is making sure that this this functional debilitating condition can be cleared up and get like a nice kind of continuation of care into what do you do once you rule out the scary stuff. And that's what doesn't exist right now. So that that's kind of my next goal is is to open that line of communication and make it a lot more simple for your general practitioner neurologist to say great everything's ruled out that's fantastic you're gonna say see Dr. Wolf and she's gonna take care of the migraines.

Dr. Ayla Wolf: 44:06

That's where we want to get to yeah and then talk to me about vestibular migraines and I'm also curious if you've had uh if you've found that the MQ7 helps in those cases too or if you're uh approaching them completely different.

Dr. Adam Harcourt: 44:19

Yeah and and I'll lump that in with hemiplegic migraine as well because I what what's interesting about all these different variations is they get treated as different disorders. They're they're all migraine right they're all migraine and so when we talk about you know the bucket theory and this hyperexcitability and all this stuff it's the exact same thing but instead of being in the area that inhibits head and face pain it's in the area that controls balance or controls facial movements or whatever. I just I I had a hemiplegic case come in two days ago and it was post-surgical. They they had a history of migraine they had a history of a little bit of facial drooping but now after surgery they came out full facial drooping they have full tingling and numbness and at first they go you're having a bunch of TIAs and then they're like but we're not seeing them on imaging so we're not sure what's going on which is common hemiplegic migraine is not not super common. And so with vestibular migraine or hemiplegic I still do the MQ7 and the MGR. Now for me with hemiplegic migraine I had no reason whatsoever to think that MGR would be helpful with the hemiplegic symptoms. And so I never recommended it. And I had a few cases where they had both hemiplegic migraine and classic migraine and I had about three about three patients in a row all say you know what was weird? I had the headache I also had the hemiplegia come on I took the MGR and my hemiplegic symptoms went away. I don't know why. I'm just being honest I have no idea why that happened. But it has helped so I go all right well it's better than whatever else you were taking and so we still start with the the diet the hormones like I had a hemiplegic case that um had been couch bound basically for seven months they couldn't move and we just started remotely because they were in in uh central they were in the the middle of the country and they just did the nutrition and hormones and got like 78% better just from that. And they're like but it was stroke why are they getting better? It's like no it was migraine. And so if it's vestibular migraine I still start with the base of the nutrition and hormones but the therapy as opposed to being straight you know trigeminal or going after that that kind of upper mid-brain stem, we do a lot more that affects the lower brainstem, right? The vestibular system and things like that. So the neurological rehab might be a little bit different, but the approach is still exactly the same and same thing with hemiplegic migraine.

Dr. Ayla Wolf: 46:33

Yeah so as kind of a take home for our listeners there's this concept that whether you're having a migraine manifesting as head pain or a vestibular migraine manifesting as extreme vertigo or disequilibrium or a hemiplegic migraine which is manifesting as paralysis, temporary paralysis of the face or an abdominal migraine where you're having nausea it's that this is the hyperecitability in the brain and based on where the hyperecitability is, it's affecting different systems and then people are having these different symptoms as a result.

Dr. Adam Harcourt: 47:07

Exactly yep that's exactly right and interestingly about abdominal migraine you you might see something different than I have but um I I have yet to see a case that was actually abdominal migraine everyone that I've had ended up coming back to figuring out oh no they actually had a really bad concussion that brought on all these symptoms. I'm not saying it doesn't exist. I'm just saying every case I've ever seen initially they would say yeah it's migraine it came out of nowhere but upon like I had I had one kid he came in like yeah it's they say it's abdominal migraine abdominal migraines it's miserable and they came in and it turns out he goes oh yeah all this started after I was sailing and the boom came around and hit me and knocked me off the boat. I go and you didn't ever have any symptoms before that they go no I go maybe that was it. Maybe that had something to do with and so I mean again they because these are there's not an objective way to say which is which my guess is there are people that have these abdominal migraines that are really lower brain stem and that's where that's coming from but the vast majority I feel like are diagnosed as abdominal migraine because of the nausea and the different symptoms that aren't as classic I guess with with post-traumatic um headaches or post-traumatic um concussion syndrome and when in reality they're just a knock to the head right and so that's just an interesting observation I've had uh over the years is I just haven't seen one yet. It's just very interesting. Yeah yeah interesting and then let's talk about barometric pressure because a lot of people that suffer from migraines uh become their own weathermen in a sense that as soon as the barometric pressure changes they they get a migraine yep yeah yeah the way I describe that is is when we talk about the bucket theory which we didn't talk about here but I'm sure you've talked about it is if you imagine that part of the brain that's hypereccitable for whatever type of migraine you have, you imagine it as a bucket because as stressors, right, hormonal stress, musculoskeletal stress, nutritional stress, whatever it is, fills up that bucket and the bucket overflows, that's when you get migraine. Now you we technically we talk about it this hyper excitable state and all that, but the bucket makes sense. And what's interesting is over time the bucket can either get bigger or smaller. So if you have two migraines a year, right, you have a big old bucket it takes a lot of stress for you to end up having that migraine. But now it starts being every month, every two weeks every week every other day and eventually you get to the point where the bucket is so small that even if you go in, let's say you get acupuncture and it's wonderful for you, there's too many other things filling up the bucket so it looks like oh that didn't work I'm going on the next thing. And you try chiropractic and it's great for you, but the bucket's so small so it looks like it didn't help. And you move on to the next thing. And this keeps happening over and over. That's why with chronic migraine we approach it in this comprehensive manner where we look at all the different things and we try to remove things from the bucket but stimulate the area that is involved in the migraine so that it creates more proteins, makes it less hyperexcitable and makes the bucket bigger the way this relates to barometric pressure is believe it or not, I haven't figured out how to control the weather can't do that yet. So I can't empty the bucket. But what I can do is I can make the bucket bigger okay and so what we find is as people get better and they get more stable, they'll get to a point where they'll feel the bare they'll still feel the barometric pressure they'll feel everything that usually leads up to that migraine and then it just doesn't it doesn't come on right and what that tells me is the bucket's gotten big enough where it was filling up, right? It was getting close to being hyper excitable and it didn't quite make it over the edge. Okay, we've got it big enough. Hallelujah we know we're in great shape then and that's that's kind of how you treat exogenous stressors that you have no control over whatsoever. You're not gonna get rid of that stressor just like I had one one time where um she was doing really well and then she started spiking up headaches. I go, what the heck happened? She's like my mother-in-law moved in with us I go oh I can't can't take that stressor away sorry let's keep working on the things to make that bucket bigger and that's what we did. So there's always things you can't control. That's why I'm a very very kind of staunch advocate of continuing with exercises until you feel really stable not because you're gonna get a migraine if you stop doing them, but because we want to make that bucket as big as we can. So when inevitably those big stressors come along, it's not taking you out for for weeks or months.

Dr. Ayla Wolf: 51:24

Yeah yeah that makes sense so it's uh when people tell you that it's really just an indication of kind of where they're at in terms of how full is their bucket or how big or small is their bucket. And your approach is still technically the same. Let's try to decrease the hyperexcitability in the brain let's try to stabilize the brain through active neural rehab create those proteins that create the the proper voltage of the cell membrane so that it's not so hyperexcitable.

Dr. Adam Harcourt: 51:49

That's exactly right. Yep.

Dr. Ayla Wolf: 51:51

Awesome well why don't you give us uh some information on where people can find you uh where your clinic is and then some of these other things you have going on I know you also wrote a book that is probably chock full of helpful information for people.

Dr. Adam Harcourt: 52:04

Yeah yeah so um we're at Hardcourt Brain Center right it's the easiest thing is just look on uh Google you can find us pretty easily we're in York Pennsylvania uh we're also on on Instagram it's at mygrain doctors so we've been on there for quite a while a lot of content there um anything I I think I have part of my speech from Hopkins we were on uh when we was with Dr. Drew doing his podcast that's on there so lots of cool stuff uh to look up a lot of helpful hints you know we do things for the holidays things like that so it's a great resource um for us um I did write the book it's not not available very easily right now but that hopefully will change soon so uh it used to be on Amazon it'll probably be available on a different website um we are yeah we are working with biogenic nutrition so there's some really exciting things that will be coming out in the next couple months um through them so some at-home things that you can do um on your own and then as as we kind of alluded to um we're also looking at a couple different research papers one actually with laser therapy because there's there's not a lot out there about it but so there's some really cool things that we've been doing. So that's one study that's going to be coming out. And then there's another one we're gonna start looking at with with eye movements, being able to track those and then kind of quantify that. So again that's that's all coming down the pipeline. But um easiest way is just look us up online or go to Migraine doctors at uh at Instagram.

Dr. Ayla Wolf: 53:17

Excellent well I'll post all that in the show notes and then once your book is available uh I can also put that on my Instagram and and get that out to people too.

Dr. Adam Harcourt: 53:25

Perfect that sounds great.

Dr. Ayla Wolf: 53:26

Yeah well thank you so much for sharing all your wisdom your experience and uh it's been a great conversation.

Dr. Adam Harcourt: 53:32

Yeah thanks so much for having me.

Dr. Ayla Wolf: 53:34

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