The past few years have brought us many new treatments from medications like gepants, to neuromodulation devices. Using gammaCore for vestibular migraine has always interested me as an alternative to medication, but like many patients I found it risky due to the expense.
It wasn’t until I struggled with postpartum vestibular migraine symptoms that I reached out to my neurologist to discuss if this device could be an option for me. After using it for a little over a year, I feel comfortable writing about my journey with you all as a fair and accurate review.
This article was written by gathering input from Dr. Edward Cho at Beverly Hills ENT and Dr. Shin Beh at Beh Center for Vestibular and Migraine Disorders. All opinions about my experience using gammaCore for vestibular migraine are my own and not a substitute for medical advice.
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What is the Vagus Nerve
You’ll hear a lot of physicians in the vestibular migraine space discuss the “vagus nerve” as well as the “gut-brain connection”. These two things are intertwined as the vagus nerve is responsible for connecting your gut to your brain. It is a part of the parasympathetic nervous system which controls body functions such as digestion and heart rate. It is also the longest cranial nerve, which runs from your brain to the large intestine.
Ever get a gut feeling? That’s your vagus nerve! It can also have a big impact on sensory functions and movement, as well as mood.
Seeing a connection here? With vestibular migraine often coming along with anxiety, sensory issues, and digestive upset, it makes sense why the vagus nerve would be an important factor.
For someone like me who struggles with a fast heart rate and anxious feelings during attacks, as well as nausea and vomiting, I felt like it could be a good fit.
Vagus Nerve Stimulation
For severe conditions like epilepsy and depression, vagus nerve stimulation is used, also known as VNS. In this case, a small device is implanted into your chest, connecting to the nerve. The device then sends electrical signals through your vagus nerve to the brain to calm down irregular activity.
Vagus nerve stimulation is being studied for being studied for inflammatory bowel disease, cluster headaches, and even PTSD. However, the implanted device is not something that is approved for migraine.
gammaCore is the first FDA cleared nVNS device, where the “n” stands for non-invasive. Nothing is implanted, the device simply stimulates your vagus nerve by sending a similar electrical signal when it’s placed along the neck, just under the chin.
Benefits of Vagal Nerve Stimulation
Studies have shown that people with a strong vagal tone are more resilient to uncontrollable circumstances. Benefits include:
- Easier to relax after a stressful event
- Improve mood and anxiety disorders
- Better manage inflammation
- Aid in the improvement of gut issues
Another positive to using an nVNS device like gammaCore is that although it hasn’t been studied in pregnant patients, many physicians are recommending it as a safe treatment during pregnancy, and especially postpartum with breastfeeding. (like to the AMD video)
I know all too well that it’s difficult to manage a newborn and migraine attacks at the same time. You need to be alert as a parent, but also many medications for acute treatments can cause side effects that make you even more tired. This is where having a device can be helpful.
The Details
gammaCore has been clinically proven to provide headache relief, as well as acute relief from vestibular migraine symptoms, like vertigo. This is according to a 2019 study done by doctors Beh and Friedman.
- Prescription Information - The device is prescribed by a healthcare provider. Your neurologist may be a part of their "pilot program" so check with them first for a good deal. If not, you can ask your primary care doctor or other physician to prescribe with this form and then submit it through the gammaCore website using my discount code.
- Cost - You can try gammaCore for as little as $130 a month for 3 months with the code dizzycook. Check with your insurance to see if they will cover it as well. HSA and FSA accounts can also be used. If this is too expensive, you can look into Truvaga, which has fewer sessions so not as good for someone who needs a lot of acute and preventative uses.
- Discounts - This is completely free to veteran and military members through the VA. You may also want to see if your physician has a discount.
- Shipping - The device is shipped to you, and you can schedule a meeting with their team so they show you how to use it. It’s important to do this so you’re using it properly, otherwise you may not see benefits.
Each refill card from gammaCore comes with 3 months pre-loaded. This is important because, like any treatment for migraine, it takes roughly 3 months of regular use to see if this is a treatment that will work for you.
How to Use gammaCore
Each stimulation session is two minutes, and it’s suggested to do two sessions at a time for a total of 4 minutes. Each device has 24 sessions a day pre-loaded with every refill card.
For preventative use - It is recommended to use it at least twice a day, morning and evening. Sometimes your provider may recommend three times a day. This is something that should be discussed with your physician.
For acute treatment - Use the remaining sessions to start a stimulation whenever you feel symptoms come on. There is no risk of overuse with an nVNS device like there is for triptans or other medications.
- Begin by using the provided electrode gel to use a pea-sized amount that covers both nodes.
- Place alongside the neck (on either side) slightly tilted and increase the intensity level to between 15-25 for optimum results. Mine typically hovers around 15-20.
- Move the device around slightly till you feel a tightness in the side of your neck and also your lower lip will begin to pull to the side. This is not permanent. Your lip will go back to normal once the stimulation has ended. Promise! If your lip is not pulling down, try increasing the intensity level.
- Wait until the device beeps, indicating your session has ended. Immediately start up your next session. Sometimes I try to not move the device too much so I can find the specific spot quickly!
Side Effects - The only side effects for me are the tingling and tightness sensation as well as the lip pulling. And all of those go away when you stop the stimulation.
Relief usually happens almost immediately, or within the hour. If I don’t receive enough relief, I’ll do another stimulation.
My Review of gammaCore for Vestibular Migraine
The main selling point for me with choosing this device over others was that I was experiencing vestibular migraine symptoms along with intense postpartum anxiety. Although it hasn’t been studied for being helpful for this specifically, I thought there might be a connection since stimulating the vagus nerve seems to help regulate that stress response.
As far as acute relief, I noticed a difference immediately in the intensity of symptoms. The dizziness and head pressure didn't go away, but I felt a little more relief and almost relaxed after my first stimulation.
It took me about two to three months to begin to a notice a large difference, and because I did have a newborn, I wasn’t great about being faithful with using it everyday.
I think I could’ve seen a difference faster if I had been more dedicated. But alas, I was lucky some days if I could remember to drink water.
After the initial period, I noticed that gammaCore was really effective at aborting vestibular migraine attacks that I felt coming on, or at least bringing down the intensity.
- A stimulation at the first sign of dizziness.
- Increase my stimulations for the day if my trigger load is high - lots of bad weather, stress, not eating well, or traveling.
- I try to use 3 times a day, morning and night for preventative use. I used to do 2 times a day, but noticed a lot more relief from nausea increasing to 3 times a day.
gammaCore has actually helped me stay off my migraine preventative medication, even through a really rough postpartum period. Initially I was having attacks every few days, especially with a lack of sleep. After a year of regular use, I only need it acutely fewer than 5 times a month.
Is nVNS Right For Me?
If you experience a combination of any of the following, I would definitely ask your physician about trying it for 3 months to see if this is a good addition to your current treatment.
- Anxiety
- Dizziness or vertigo associated with vestibular migraine
- Gut health issues
- Cluster headache
It’s also helpful for people who either need to avoid medication due to side effects or are trying to manage migraine without medication.
Frequently Asked Questions
No, unlike triptans, you can use gammaCore as an acute treatment everyday.
Cost can range anywhere from $200 a month to less, with certain discounts. Use the code dizzycook or check with your provider to see if they have discounts or if you can get insurance to cover it. If this is too expensive, you may want to look into Truvaga, which has not been approved for migraine, but is a similar device with fewer sessions. gammaCore is best for people who are chronic and high frequency users.
This is a tricky subject. Short answer is some do, but you have to be your own patient advocate as many leave it up to your plan to decide. It’s worth checking, but there is very limited insurance coverage and you may end up waiting a long amount of time to end up being denied.
Although it has not been studied, many providers consider gammaCore safe during breastfeeding and a really easy option! Some physicians are recommending it for patients who cannot use medication or are going through the IVF process (see AMD’s preconception webinar).
Not for me! But everyone is different and some people may find the stimulations uncomfortable. In that case, try lowering intensity. It should never be painful. I certainly don’t love the feeling, but it’s not overly uncomfortable. To me, it just feels like neck tightness with a vibration or buzzing. If you do experience any kind of pain, please just reach out to them and I’m sure they’ll be happy to work with you.
If you’re not experiencing the lip pull, you may not be in the right place and therefore aren’t getting the full benefits of the device. One thing to check is the intensity, make sure that’s at least over 15. I often find it easier to locate the right spot with a higher intensity. The other trick is to switch sides. It takes a few times to get the hang of using it. Finally, check the amount of gel, you may need to add a lot more. If you need more help, they do offer video consults! They can be reached at 888.903.2673 or through instagram.
Email customerservice@electrocore.com or check their contact page which has individual services for US, UK (visit here if you’re in Europe outside of the countries listed), Australia, New Zealand, Qatar, Cyprus, Canada, France, Belgium, and more.
Natural Ways to Increase Vagal Tone
In my discussions with Dr. Cho, he believes there may be a large group of PPPD and vestibular migraine patients that have an over activated fight or flight response that could benefit from natural vagus nerve stimulation. gammaCore is just one way to stimulate the vagus nerve, but there are other methods you can try too. These include:
- Cold exposure - Cold showers, cryotherapy, or cold baths.
- Deep and slow breathing - Try 10 second breaths, timing the inhale and exhale.
- Singing or humming - These can strengthen vagal tone.
- Meditation - Increases vagal tone and promotes mental health.
- Exercise - Walking, weightlifting, or any exercise that you can keep up with consistently.
- Omega 3 fatty acids - Plant sources include chia, hemp and flax seeds. Eggs and seafood, especially salmon, are other ways to include this in your diet.
- Massage - Including reflexology.
These are all things which have been incorporated into my regular routine without even knowing I was increasing my vagal tone!
Vestibular Migraine Posts
Have any more questions about my experience using gammaCore for vestibular migraine treatment and prevention? Leave a comment!
Stephanie says
Hi Alicia,
My symptoms tend to be nausea, fatigue and some dizziness. Did you find this a good match for the nausea?
Alicia says
Oh yes! I have the same symptoms. My neuro actually chose this over the other devices for me because the vagus nerve connects to your digestive system. I will say I used it throughout my pregnancy with hyperemesis and it couldn't quite overcome that, but for migraine nausea which is generally a lot less for me than pregnancy, it does help!
Jennie Vernon says
I noticed you said that you’re now using the Truvaga for maintenance. Are there differences between the GammaCore and Truvaga, aside from the number of permitted treatments? According to the company, the two devices deliver the same pulse, but GammaCore permits many more treatments in a shorter time span than Truvaga. Since you first wrote your review, I’ve read that GammaCore costs patients $600 per month. Is that your experience as well, or are you aware of any way to get the lower cost you mention in your post? Thank you!
Alicia says
Hey - so I wanted to try Truvaga just because I had A LOT of people asking me about it, and my attacks are fairly infrequent. They are very similar devices, but Truvaga is considered a "health device" so not suitable for the treatment of migraine, whereas the GC is FDA approved and requires a prescription. I do notice using Truvaga that it's a lot easier to find my vagus nerve since the nodules are larger. To be honest, I don't think Truvaga is a great fit if you're trying to use it off-label for migraine unless you're super episodic. It saves you money, but it's not enough stims to use preventatively in an effective way. I've found the more often I use my devices, the better they are. Now for digestion and sleep, truvaga has been amazing for me! I'll use it extra sometimes on really tough days too.
My discount for gammacore is "dizzycook" and you just tell them when you put the prescription in or I think can write it on the application. Truvaga discount is here and it's AFFILIATE10.
Gabe says
This is the first I've heard of vagus nerve stimulation for vestibular migraine relief! Thanks so much for posting this. I did notice that I had fewer vestibular and other migraine attacks when I was doing yoga daily, with lots of stretches to tone the vagus nerve. Your description of the device makes it sound very similarly to a home hand held facial muscle rejuvenation stimulator I had purchased as well.. now I'm wondering if I could apply that to my vagus nerve for a similar benefit. I think the thing was about $90, with no limit of uses, perhaps this could be worth try for folks on lower budgets. and it's good to keep in mind that all vagus nerve toning practices in general (stretches, singing or humming, cold water dips or splashes on the face, etc) will be very beneficial as well!
Michael says
Alicia,
Do you still use Gammacore daily? Did it start working straight away if you had violent dizziness?
Alicia says
So I haven't had violent dizziness in a few years because I'm more well controlled now. But yes, I still use daily and it worked immediately to bring down any dizziness or anxiety I was experiencing. But it didn't fully get rid of it. It worked better with daily use over time.
giulia naccarato says
Alicia, I cannot thank you enough for all the help you and the Dizzy Baker have given me. My life has been a nightmare since my first vertigo attack in my life back in late june had me in the hospital dehydrated and terrified. After hours of vertigo with vomiting and diarrhea and the awful feeling I could NOT move my head. I wished I was dead. After MRI, CT scans, Heart scans, sinus xrays , hearing tests, VHIT, VeMP, etc etc. I am finally diagnosed with MAV or vestibular migraine. If it was not for you and Dizzy Baker-(I bought your cookbook and it so helpful) I dont know where I would be today. I am 53 yrs old-use to get migraines and AURA but never had vertigo or dizziness ever just the head pain and nausea.. Well I have not left my house unless to go to the multitude of doctors--still I had three more severe attacks. The last one not as bad as I had started nortriptyline for 4 weeks .. Anyway --God Bless you for your positive outlook, for recommending Dr Behs book and for all your tips... With Jesus and a positive outlook I am praying to end this misery.. along with the meds and this Gamma Core I just got a script for.. . (i am in Chicago so saw Dr. Cherchi but my diagnosis was suspected by a great family doc. and a caring ENT).
My most sincere thanks.. Giulia F Naccarato
giulia naccarato says
I need some help. I have been trying to order the product since last Friday. I am not able to do so through the portal. It keeps getting stuck, it is confirmed they have my prescription.. Please help.. i have called and left 2 messages along with many email messages. They are not calling me to resolve the issue. for someone with vestibular migraine and dizziness this has been a miserable experience. HOW did you even get to order yours? please help if you can email me.. I appreciate it.
giulia says
Great news, Vytal and Gamma Core both contacted me and apologized, not sure why my order had so many glitches. They are sending me the product overnight due to the delays the system caused.
I hope to report back once I use this daily for awhile.. I am praying for a miracle.
Alicia says
Hey, that's great. I contacted them yesterday to make sure they reached out. Let me know if you have any more issues!
Scott says
I'm interested in trying the Gammacore, but I'm quite confused on the price. Is it 150 per month only for the first three months and then the price goes up to ~600 per month or is the 150 per month the standard price now? I too am having vestibular migraine symptoms with very rare head pain and suspect the vagus nerve stimulator might help. Thanks!
Alicia says
Hi Scott, using my "dizzycook" discount through their website it's $130 for the trial and then goes up to $170 a month. I hope that helps! 🙂
Kayla says
Could I get the device in South africa
Alicia says
Hey Kayla - I'm not sure but try emailing them at the email I give to contact them above! They may be able to have the UK office send you one.
Jamie says
Great post! I’ve been using GammaCore for a month now and and starting to see the benefits. A couple times I’Ve used it acutely and have noticed a quick drop in my dizziness. I’m also using it 2-3 times a day for the preventative benefits as I’m weening off my preventative medicine and at this point have noticed a positive impact on my gut functioning! Daily dizziness is also decreasing and I’ve had more 100% days as I did on my full dose of preventative Rx. Thanks for bringing this nifty device to light!!!
Alicia says
Thanks for sharing your experience, Jamie. So happy to hear it's been helping others too. I did notice the decrease in dizziness fairly fast as well.
Brooke says
Thats great Jamie! Is it still going well? I am only a couple days in but so far so good! Not sure if its just a good week or the device is helping. Although I never have this many low symptoms days in a row.
Alicia says
Yay, Brooke!
Fran says
Can vagal nerve stimulation cause a stroke in seniors
Amanda says
Ok that makes sense! I saw that you wrote it only takes 2-4 minutes; that is definitely an advantage! I have a 2 month old and am determined to find 20 minutes each day for myself, haha! I'm just so happy there are new and non-invasive options now. Keep up the good work, Alicia.
Mich says
Hi Alicia,
Did the device end up helping with the anxiety component?
Thank you!
Amanda says
Hi Alicia,
Thanks for the post! What made you choose gammaCore over Cefaly? I just started using the Cefaly and am excited for the possible results. My neuro recommended Cefaly because of the price, being cheaper overall than gammaCore and the 90 day return policy. I am wondering if I should've tried the gammaCore instead. Thanks!
Amanda
Alicia says
Such a good question! So I don't experience head pain with my attacks and the trigeminal nerve is usually synonymous with that so that's why I gravitated towards gammaCore to try first. My symptoms are more anxiety, vertigo, and also nausea, so I just felt like the vagus nerve stimulation sounded like a better fit for me. Plus with a newborn I felt like 4 minutes of stim was a lot more doable than 20, even if it's hands off. Dr. Beh did mention in our recent video that trigeminal connects to your vestibular system so he sees success with both, but generally those people do have a head pain element. Price is definitely a factor. If you choose gammaCore I posted a discount on my instagram.
Amanda says
Ok that makes sense! I saw that you wrote it only takes 2-4 minutes; that is definitely an advantage! I have a 2 month old and am determined to find 20 minutes each day for myself, haha! I'm just so happy there are new and non-invasive options now. Keep up the good work, Alicia.