I have had chronic migraines for over 30 years that trigger autonomic issues such as numbness and discoloration in toes, severe muscle tightness head to toe, as well as vertigo and aura. I have a few different types of migraines but the one consistent thing is my neck and traps are always in pain. I've read many lectures on MigraineWorldSummit and it prompted to me to get a continuous glucose monitor (CGM) and have functionhealth run their full annual blood work. There are a few things that came out of that blood work that doctors have never tested for, not even Mayo: I have low Leptin, low Insulin, and extremely low Omega 3 levels. Because I am lean, I apparently do not have enough 'fat' and subsequent fat hormones (Leptin and Insulin) to effectively manage by blood sugar. The low Omega 3 was significant as a deficiency cause both headaches/migraines, as well as muscle tension and pain. My CGM showed that during the night by blood sugar drops to 52-54 for extended periods of time - I am no where near a diabetic, but rather would be considered hypoglycemic. Doctors only appear to screen for diabetes and have never looked into whether I have blood sugar issues. Not maintaining a consistent blood sugar (minimal spikes and lows) combined with low Omega 3 is a key contributing factor for me. I wish doctors and Mayo would put some extra focus into these key biomarkers that are linked to migraines - I have been complaining that my muscles are constantly tight and painful and I see a Neurosomatic Therapist for muscle stripping that gently realigns my c-spine (through releasing knotted muscles) yet these basic biomarkers that contribute to muscle health have not been tested for by doctors (only inflammatory markers).