A detailed headache diary is the single most powerful diagnostic tool

Full analysis

Brian Grosberg uses 15-page intake questionnaires and asks patients to keep a month-view headache diary tracking timing, triggers, sleep, caffeine intake, menstrual cycle, and medication use. He gives the example of a patient whose migraines clustered on weekends: the diary revealed that on Friday nights they stayed up later, slept in on Saturday, and delayed their morning coffee — three simultaneous triggers that they had never connected. Grosberg's practice makes a downloadable diary available on its website (linked in the episode's show notes), and he encourages anyone seeing a primary care doctor about headaches to complete it in advance so the clinician can act on rich data in a short appointment. He estimates the diary requires about 20 minutes a day but produces insights that can guide treatment decisions no amount of wearable tracker data can replicate.