Ketogenic Diet and Migraines: Assessing and Treating Them

Migraines suck.

Not only do they ruin the day they happen, but they can also kill brain cells. That is not an exaggeration. When a severe, throbbing pain lasts for several hours, listen.

The Ketogenic Diet Helps Reduce Migraines

Stop. Pay attention. Why is this migraine happening? This intense pain is a deep, primal signal from your brain screaming for help.

Brain scans allow us to look at what happens to the brain during a migraine. We can see what happens on the brain scan as the patient experiences a migraine.  The brain area “under attack” swells the longer the pain continues.  

Originally thought to be from disrupted blood flow, there‘s way more to the story of what happens during a migraine.

Experts summarize the mechanisms causing migraines as “neurobiological changes that occur in the brain.” That fancy talk does little to help my patients and their families understand the cause, the scope, or the cure for the problem.

I explain what happens at a cellular level during these torture sessions.  The brain-cell chemistry shifts causing swelling in that area of the brain.

The influx of swelling contributes to the early onset of death in those brain cells. Yes. You read that correctly.  The cells affected by a migraine die sooner and more often.

The death of our brain cells usually takes time and happens with age. Scan an 80-year-old-brain and you find imperfections in their brain scan.  Scan an 80-year-old with high blood pressure for years and see many, many more defects in their brain.

Want to kill off brain cells the fastest? Put the brain cells under high pressure with lots of inflammation. Maybe your brain teeters on the edge of diabetes with “only slightly elevated” blood sugars.

Maybe you deny your brain the proper healing time by chronically living on 6 or 7 hours of sleep. Now add the chemical mystery of a migraine: BAM!  The perfect storm for coaxing brain cells to die sooner than they should. The longer that brain cell stays swollen, the more cells die.

IS MY HEADACHE A MIGRAINE?

Ask yourself these questions:

• Has a headache limited your activities for a day or more in the last three months?
  
• Are you nauseated or sick to your stomach when you have a headache?
  
• Does light bother you when you have a headache?

If 2 of the three are true, chances are quite high that you damage your brain with every headache.  When teaching students or patients how to pick out a migraine from a minor headache I use the word POUND.

 Although, brain experts argue over the exact mechanism for why the brain glitches into this searing pain, all agree there is damage happening.  The scans show lost white matter in the brains of patients suffering from years of repeated migraines.  Indeed, the frequency and severity of your migraines unequivocally contribute to how many brain cells die.

Don’t rush to the MRI machine the next time you get a headache. Instead, focus on stopping the underlying cause of those migraines.

The good news: brain swelling is reversible with treatment.

TREATMENT

In past years, this would be when I would chirp at patients to do the following:

• get 8 hours of sleep,
• stop drinking alcohol,
• fix your anxiety,
• reverse your depression,
• stop smoking cigarettes,
• and lose weight.  

Also, they should take up meditation practices to lower stress along with turning off all electronics 2 hours before bed.  

Those recommendations still stand strong. But that list is impractical to start tomorrow and expect perfect performance going forward.  That list often leaves patients hopeless and overwhelmed.

I have yet to see a patient walk into my clinic and say, “I want to be on the ketosis diet because I heard it helps with migraines.” I hope to hear that someday.

Teaching patients to produce ketones has become the most effective way to get my patients off of migraine medication and into a healthy, pain-free life. After years of coaxing them to tackle that list written above, my approach now is to PEE A KETONE FOR 6 WEEKS.*  

I Find That This ONE Change is The Best First Step.

The root reason is the anti-inflammatory effects of ketosis. The authentic antidote to migraines is to remove the inflammation in that area of the brain.  Ibuprofen or acetaminophen certainly help a little bit. But bathe your brain with ketones for several weeks and watch the headaches evaporate from your life.

As patients continue to practice the keto-lifestyle, other improvements get checked off the list. Their sleep is better and more profound.  It doesn’t mean they can go with less than 8 hours. However, many of my migraine patients struggling with sleep problems. The magic elixir to sleep lurks in that third week of ketosis. That also seems to be when their mood improves.  

Each week into ketosis, more patients report a complete end to their migraines – usually within six months of peeing on that first ketone stick.

Just like other chronic problems, migraines don’t cause brain damage overnight. Similarly, recovering from years of swollen and damaged tissue takes time.

The longer patients stay in ketosis, the more thoroughly they remove the amount of extra brain swelling. At first, the water gets shed from their legs and bloating in the gut.

Over the next few months, patients also experience water removal in your skin, joints, eyes, and brain.  Those who stay in ketosis can’t help but observe the following: glowing skin, better joint movements, improved eyesight and overall less pain. These positive improvements show up around the 3-6 month mark, precisely the time most patients’ migraines disappear entirely.

For more information about ketosis, check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.

RESOURCES:

1. Achanta, Lavanya B., and Caroline D. Rae. “β-Hydroxybutyrate in the Brain: One Molecule, Multiple Mechanisms.” Neurochemical Research, vol. 42, no. 1, Aug. 2016, pp. 35–49., doi:10.1007/s11064-016-2099-2
2. Bergin, Ann M. “Ketogenic Diet in Established Epilepsy Indications.” Oxford Medicine Online, 2016, doi:10.1093/med/9780190497996.003.0006
3. Craig, Courtney. “Mitoprotective Dietary Approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric Restriction, Fasting, and Ketogenic Diets.” Medical Hypotheses, vol. 85, no. 5, 2015, pp. 690–693., doi:10.1016/j.mehy.2015.08.013
4. Lorenzo, C. Di, et al. “Migraine Improvement during Short Lasting Ketogenesis: a Proof-of-Concept Study.” European Journal of Neurology, vol. 22, no. 1, 2014, pp. 170–177., doi:10.1111/ene.12550.