Saturday, January 16, 2010

Migraines: Are They Preventable?

A link between migraine headaches and epilepsy has been known or suspected (depending on who's asked) for a long time.  For the last century or so, a ketogenic diet has been used with a lot of success to treat epileptic patients.  We'd like to know if that suggests anything about its efficacy in the treatment of migraines.

This would probably be a lot easier if we knew more about the causes and physiologies of epilepsy and migraines, but we should be able to get some hints from what we do know.  For example, migraines seem to correspond with an unusually alkaline blood pH and to respond favorably to lowering it (making it more acidic).  On a very-low-carb diet, the blood is very acidic because the ketone bodies themselves are acidic.  This may account for the success of the diet in treating urinary tract infections.

Another place doctors are looking for the cause of migraines is GABA, an important neurotransmitter.  Ketosis has significant effects on GABA metabolism, which is specifically targeted by lots of migraine and epilepsy medications with great success.  Ketosis, in many important ways, mimics the effects of these drugs.  Or to put it another way, the drugs mimic the effects of ketosis!

Another very important neurotransmitter is glutamate.  It's also a chemical precursor to GABA, so there's a lot of interplay between the two in the brain.  Impairments in the metabolism of either chemical, and in the conversion of glutamate to GABA, have been implicated in a number of neurological problems, including epilepsy and migraines.  The ketogenic diet increases the rate of conversion of glutamate to GABA, which would tend to protect against these problems according to our current understanding of them.  The article I'm going to use to back up these claims is positively dense with great information, and if you can handle scientific literature written for scientists you might want to check it out: The Neuropharmacology of the Ketogenic Diet.

All this is mostly theoretical, of course.  A few rigorous studies that have been done to figure out if migraines can be effectively treated with a ketogenic diet, but unfortunately their full texts aren't freely available online.  This one has some of the results available, and they're interesting enough that I almost want to purchase the article.

What I did find with little trouble is quite a bit of anecdotal evidence of people treating their own symptoms with the diet.  Some tried the diet to lose weight and realized they stopped having migraines.  Some of them remained migraine-free even after stopping the diet, which matches up with some of the published results.  If any of you migraine sufferers feel like experimenting on yourselves, or if you already have, I would really love to hear about it.

40 comments:

  1. I think I'll see if I can get my wife to try it.

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  2. If you can get her on board, I'd love for you to keep me posted on the results.

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  3. I also have been trying a diet so similar to this called a Paleo diet. It's fairly low carb, except there are more fruits and veggies in it. I've lost from 320 down to 280 pounds in 2 months so far. Not gone ketotic yet, but I suppose I could, though I never get headaches myself.

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  4. I'm a big fan of the Paleo diet, but I think ketosis confers a lot of benefits that Paleo doesn't. I'd go on about that, but that's what the blog is for :)

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  5. I actually found your blog because I was trying to figure out if it was possible for carbs to even cause migraines. The backstory is that I was having almost daily horrible headaches and was finally put on a migraine preventer and relpax. I was feeling great for three weeks so I thought the medicine was finally working. I also happened to be in ketosis cutting out most carbs but still eating fruits and veggies because I would be unable to make it to the gym that month due to my schedule. Finally had time to get back to the gym so I began eating normally (cereal for breakfast, sandwich for lunch, etc) and my headaches returned with an awful vengeance. I was still on the medicine so I was trying to figure out what happened. It finally clicked that the only thing that had changed was my carb intake.

    I am five days back in ketosis now and also five days without headaches. The day I went in ketosis it was like a headache switch turned them off.

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  6. Awesome mii, thanks so much for sharing your experience!

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  7. i think another problem with migraine is link of calcium .too much intake of calcium provokes muscle tension headache .
    so to relax muscle gaba alongwith 5htp should be used .
    Riboflavine 400-500mg divided dose should be used
    Magnesium 1000mg divided dose should be used

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  8. Naimesh that's an interesting take that I think I'll look more into. But muscle tension headaches, which I get pretty frequently, are very distinct from migraines, which I've never gotten.

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  9. Any person suffer from migraine can get relief from
    5htp 100mg or 200mg , GABA 750 mg,
    Riboflavine 400 mg
    Magnesium 1000 mg
    Feverfew 1500mg gnc

    For cluster Headaches start taking 1000 mg magnesium

    For classic Headaches start taking riboflavine 400 mg

    For Tension and classic Headaches start taking
    5 htp , GABA and Riboflavine 400 mg ,Magnesium 1000 mg
    FeverFew 1500 mg GNC

    5htp is converted to serotonin

    Migraine headaches seem to be caused in part by changes in the level of a chemical made in the brain called serotonin.
    Serotonin plays many roles in the body, and it can have an effect on blood vessels.
    When serotonin levels are high, blood vessels constrict (shrink).
    When serotonin levels fall, the blood vessels dilate (swell).
    This swelling can cause pain or other problems.

    While GABA relaxes muscles major part in migraine headaches

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  10. I suffer from migraines since I was 7 or 8, and I am 26 now. In my case, it appears to be genetic.
    I started training for a figure competition last year, which involved a ketogenic diet. For the 12 weeks that the diet lasted, I had not one migraine episode!!! As soon as I got back to a normal diet, my migraines became more frequent than ever before... So, according to my experience, ketogenic diets work in preventing migraines, but I do not one can live on such a constrained diet...

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  11. I tried it for 3 weeks. Lost 10kg and was migraine free (but only during that time).

    I wonder if it has anything to do with insulin - as I tend to binge on sweets and carbs and wake up with a massive migraine the next morning.

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  12. Ah, I wish this were the case for me. I actually GET migraines if I don't eat enough carbs... and I have to get enough higher glycemic carbs as well. I'm in decent shape, 19% bodyfat as a female and burn calories like crazy. My body literally hates anything close to the paleo diet! :( It is definitely a blood sugar thing... it has to be perfectly balanced or the migraines come! Stinks because I wish I could lean up more, but my body hates those diets!

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  13. Amy, that's a shame. I have an uncle who's the same way. Sounds like you're hypoglycemic. There are lots of different possible causes of that, and none of them are good. I recommend doing whatever you can to get to the bottom of it. Some of the causes can, incidentally, be taken care of with a ketogenic diet, but even then it would take time, and as you say you're likely to suffer considerably during that time.

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  14. Within a few weeks of going on a low-carb/Atkins, I was able to go off Topomax and be free of migraines. Five years ago I thought I had found a miracle when my neurologist put me on Topomax- I went from having 3-4 migraines a week to having maybe 3-4 migraines per month. I was THRILLED even though I had to pay out-of-pocket for the medicine, which is VERY expensive.

    A few months ago I started a low-carb diet for weight loss and felt so good that I decided to go off Topomax to see what would happen. I have not had a single migraine and I feel fantastic! I didn't expect that at all, and for this reason I know that I must restrict my carb intake for the rest of my life. I only wish I had known this years ago...

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  15. Some more anecdotal evidence: I started the Atkins diet about a month and a half ago upon recommendation from my doctor to help with pain from Fibromyalgia/Chronic Fatigue Syndrome. It had a negligible effect on my muscle pain, but my migraines decreased from 3-4x/week to about once every week-2 weeks(depending on triggers - weather, etc.) I found the diet very difficult to tolerate for about the first 2 weeks. It got quite a bit easier afterwards. I did lose about 5 pounds (I was normal weight to begin with). But the decrease in migraine frequency has been a major motivator to stick to the diet.

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  16. I definitely think there is a link between carbs and migraine.

    I was having a health crisis where I was experiencing migraines most days of the month (maybe 25?) despite taking amitriptyline as a preventive med. I experimented with diet a little, cutting out various possible triggers until it became apparent wheat was causing most of my migraines. The longer I abstained from wheat, the fewer migraines I experienced until now, where I only get one migraine per month during a specific time in my menstrual cycle. It seems to me that since my carb intake went way down due to cutting out wheat my migraines became nearly non-existent.

    I have just started a ketogenic diet five days ago and am already amazed at how great I feel. Depression--gone. Moods--totally stable Add symptoms--much better. I am anxious to see if I get my monthly migraine or if I can eliminate that altogether with the ketogenic diet.

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  17. I have been on a low carb anti candida diet for over a year now. As long as I stay strictly on the diet, no migraines, except for a few food sensitivity triggered ones. A great relief after having migraines for 40 years. (no kidding) I am not sure if it's candida, hypothyroidism, ketosis, leaky gut or something to do with serotonin. Maybe it's all of it? It's not glucose, I have a meter.
    Hey, If somebody figures it out, let me know, huh? Best of luck to all of you.

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  18. I am 54 and have had migraines for many years. The last three years have been awful; with 11-13 most months. I want on Inderal 20 mg this fall nad it has helped some. I have noticed that I have gained weight; especially in the past year, and so I decided to change my eating to low carb. I was not in any way expecting this, but I have not had a migraine in over a month- not even a trace! I hope this is it, and I hope other migrainers will know about low carb and try it will the same outcome. Cheers! Laurie

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  19. I'm just beginning the Atkins diet for weight loss but I have suffered from migraine all my life (I'm 28). I've been to a migraine specialist here in London and was told I suffer from 3 types of migraine: Classic, Aura and Menstrual. I'm experiencing one of those lovely menstrual headaches at the moment :( I really hope this life style change banishes my migraines for good. All the stories on here makes sense. I always seems to have a bad migraine after a night of drinking especially sugary alcohol(I understand the difference between hangover headaches and migraines and they are definitely the latter). I'm really excited to try this! I'll keep you posted as to the results.

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  20. I have been on the Atkins diet to lose weight since January. Prior to January, I used to have 2 menstrual headaches per month. On a scale of 1 to 10, they were usually an 8 and put me in bed for the night. I expected my first migraine in January and got through with a mild headache, about a 3 (not even close to a migraine). February came and went with no headache and now, here I am at the end of my 3rd cycle since I started Atkins and NOT ONE headache. Not only have I lost 13.5 lbs but the bigger plus to all of this is the migraine relief. I am thrilled.

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    1. Me too!!!!!!!! PLEASE EVERYONE THAT SUFFERS FROM MIGRAINES.............TRY A LOW CARB DIET!!!!!!!!!!!! Vomiting, days in bed, calling off sick, can't function, those days are behind me!! Praise Jesus!!!

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  21. I just realized I haven't had a migraine in months, very unusual. I have also been eating low carbs for months. Has to be a correlation.

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  22. I've dealt with migraines for nearly 25 years! They were coming on nearly every day and are being treated with sumatriptan pills and injections. 3 weeks ago I began a low carb diet..........eliminating sugar and bread, eating eggs, cheese, bacon, sugar free jello, salads and a hand full of peanuts. For the past week I treated myself one day with Advil Migraine and have had no reaccuring headaches, Praise God! We'll see..............but so far, this diet has simply taken my migraines down to one small headache a week!!!! If you suffer, please consider!

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  23. THIS WORKS 100 %
    NO MORE MIGRAINES !!!
    I HAD AT LEAST 1 MIGRAINE A WEEK...ALL GONE WHILE TRYING A LOW CARB DIET ..
    I WISH I KNEW THIS 5 YEARS AGO.
    TRY IT...YOU GOT NOTHING TO LOOSE EXEPT YOUR MIGRAINE.

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    1. Good point...what do I have to lose? I'm going to try it again. I went gluten free with my son for one month to see if it would help his skin. It did not help him (turns out he was having a reaction to nickel) but I think it helped me some with chronic migraine and IBS. I wasn't expecting it to help me so I wasn't looking for it.

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  24. how many carbs are you all eating to get this effect?

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  25. I have been following the ketogenic diet as recommended in the "Perfect Health Diet" (including intermittent fasting) for the past few weeks, but have seen no reduction in my migraines (i.e., still 2-3/wk). It's discouraging when this seems to have helped a lot of people. From reading these comments, it looks like most who were helped saw results pretty quickly. So I'm wondering how long I should continue trying this diet before I can conclude it's not doing anything for me. Has anyone found it took several weeks to start working?

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  26. I'm not familiar with that diet, but I've seen quite a few diets billing themselves as "ketogenic" or "low-carb" which admit way too many carbohydrates to be expected to work. For example I mentioned ketogenic diets to a friend as an epilepsy treatment, and she was discouraged when the one she followed didn't work, and it turned out to be 25% calories from carbohydrates, way too much to produce ketosis.

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  27. I have had migraines for over half of my life - usually 3-4/month. I started a VLCD (with a maximum carb count of 60/day) to lose weight a few months ago. I was AMAZED that I did not have my typical "3-day-starting-a-diet" migraine. In fact, during the 7 months I was on this diet I enjoyed few headaches than I have ever had. Now that I am finished losing weight and am back on "normal" food I am getting daily migraines, which are making me exhausted to the point I can barely function. This has been going on for 3 weeks, and I can only assume it is the reintroduction to carbs. I am going to try to go back into ketosis and see if this helps.

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  28. Hi! I am going to give it a go - Ketogenic Diet for migraine prevention. I have only just started and will write a blog. "Ketogenic Georgia".

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  29. As an addendum to my previous comment, I am eating less than 20-30 carbs per day.

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  30. Hmmm. I started on a low carb diet 4 days ago. I get about 3-4 migraines a year, but when I get them they are severe. Visual, blindness, paralysis, and slurred speech. Unfortunately,my low carb diet kicked one off today. Gotta stick with it a few more days and see if things improve.

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  31. I'm glad to hear you're going to stick with it. You're not likely to be in ketosis yet, and if you are there's still a period of adaptation. I'd love to hear back after you've been doing it a couple of weeks.

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  32. I usually get (well - got?) migraines a few times a month, sometimes a few times a week. I was especially prone to getting them if I skipped a meal or even sometimes just taking a few extra hours between. It would start with headaches but often even medicine didn't prevent it from becoming a full-on migraine.

    But since starting a ketogenic diet a few weeks ago, after getting through the headache/nausea fest of induction, I haven't had migraines at all. A couple headaches, but they don't develop into migraines like they used to. :) It's very encouraging!

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  33. Rocco, check out 'The Migraine Miracle' by neurologist Dr Josh Turknett - it's a new book in which he specifically recommends a ketogenic diet for migraine sufferers.

    I've had frequent migraines for a decade now; tried every medication available with little relief. Last year, I went on a low-carb diet to lose a bit of weight and noticed a dramatic reduction in both the frequency and severity of my migraines. When I went off the diet, my old migraine pattern returned.

    Needless to say, I'm just about to return to a ketogenic diet.

    Some other books I found useful were 'Grain Brain' by David Perlmutter and especially 'Why We Get Fat' by Gary Taubes, which did a fantastic job of explaining the flawed thinking behind high-carb/low-fat diet recommendations.

    Anyway, thanks for the interesting blog post!

    Cheers,

    Mike

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  34. Ok kinda long story here but I thinks it's very fitting to the line of discussion! I get severe migraines that can go as long as 10 days at a time. When I first started getting them 6 years ago I went to the hospital and saw Dr.'s but the meds never gave me relief and only caused some severe side effects...so I struck out on my own. At that time I read something talking about toxins causing migraines and that a cleanse would help. I started a fast and in 3 days the migraine was gone. So after this for several years if I got a migraine I would fast for a day or two and it would work. So I assumed it was all toxins. Some of my triggers are food preservatives and other chemicals. Sulfites in wine and dried fruit is a major one. But after a few years and a MUCH cleaner diet, I just couldn't stand to fast anymore. The migraines had gone done to a few a year rather than ongoing never ending ones, so I didn't need to fast to control them. Until Halloween 2013, that night before taking kids trick or treating my sis-in-law offered us some pizza before going out. Usually I wouldn't have, afraid of food chemicals. But it had been a year since last migraine and I didn't seem to be as sensitive as I had before, so I had two pieces....by the end of trick or treating a full blown migraine had started. Uhhhgggg, checked later and yes that company uses sulfites in their dough conditioners. Anyway, it started a 3 month migraine. Maybe one day off here and there. Six weeks in I quit gluten hoping that would help, only to find out that yes I am intolerant, because now if I get any gluten it feels like I have glass in my stomach. (Never any gastrointestinal symptoms before) so then I had a migraine and severe stomach problems until I was able to remove all traces of gluten. Next I decided to try a carb cycling diet to help remove cravings for breads etc... And hopefully lose a few pounds. Low carb days I felt good, and migraines reduced! Until the high carb days when I might eat some rice or gluten free oats etc....and the migraine would come back with a vengeance. I decided I must be sensitive to all grains. But by this time I'd started reading paleo/primal blogs for a grain free diet. On one blog, Mark's Daily Apple, I read about low carb diets to control migraines....anyway that was six days ago, and two days ago I got some hidden sulfites...got migraine but yeah! It lasted only a day and I already feel much better!!! Quickest I've ever got rid of one :) I could feel as soon as I went into ketosis because the headache diminished. Now I'm thinking that the fasting from before, that although yes it would cleanse my system it also would put me into quick ketosis. But fasting is in no way maintainable when low carb diets are....I'm very excited to start to understand this and very happy for people like you getting to word out to others! I will continue low carb and finally feel hope!

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  35. I started looking into diets to control my migraine as the tablets I have to take when I have one give me bad side effects. I realised that my preventative meds were actually an epileptic med, and remembered a story I heard about epilepsy being controlled by a ketogenic diet, I also remembered that when i was on a vlc diet (causing ketosis) I didn't have any migraines. This links my migraines with similar chemical aspects to epilepsy. I wonder if the people who do not get a relief from migraines following a ketogenic diet or low carb diet have a different cause for their migraines (chemically speaking). Hope this makes sense.

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  36. My daughter who is almost 10 has had migraines (hereditary) since she was 7, almost daily. I have put her low carb, decreasing slowly(less than 50grams/per day) a week and a half ago. The last 3 days she has been migraine free! Praise the Lord!!

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