There’s nothing that can beat people down like migraine attacks. Before you reach out for painkillers to ease the pain of a migraine attack, isn’t not having one at all better? My fellow migraine sufferers are wondering what kind of magic this is. Well, stick around to find out!
Since time immemorial people have been trying to figure out ways to prevent migraine headaches. Others go as far as avoiding certain foods because they are believed to be common migraine triggers. Research has shown that you can use ketones for migraines. Let’s see how!
What Is A Keto Diet?
Before we get into ketones for migraines, let’s refresh our memory on what a keto diet is. A ketogenic diet is a high-fat, low-carbohydrate, and moderate protein restrictive diet. Glucose is the body’s primary source of fuel. Limiting carbohydrate intake in a ketogenic diet forces the body to use an alternative energy source.
When there is inadequate blood sugar or your body is fasting, your energy metabolism is shifted from glucose metabolism to breaking down dietary fat or body fat in a process known as ketosis. This process leads to the production of ketone bodies which are the alternative fuel source for brain cells.
Many people nowadays sing the praises of the weight loss beneficial effects of ketogenic diets. But not so much is being mentioned on the effects of ketosis on migraines and other neurological disorders.
What Is A Migraine?
In 2018, one in every 6 Americans suffered from migraine headaches and one out of 5 women was affected by episodic migraine. Headache pain is the third reason for visits to the emergency room accounting for 3% of all emergency room visits annually. From statistics, migraine attacks are most common in women of childbearing age. This is because of hormonal imbalances, especially the fluctuations of estrogen during menstruation, pregnancy, and pre-menopause.
A migraine attack is considered more than a headache. It begins with prodromes and aura originating from the hypothalamus, cortex, and brain stem. It is characterized by headache pain that causes throbbing which increases intracranial pressure with an increase in headache intensity. Migraines present themselves through vomiting, nausea, and sensitivity to blue light, loud noises, and smells.
Who Can Get Migraines?
The root causes of migraine headaches are yet to be found but their risk factors include:
Cigarette smoke is one of the triggers for migraine attacks in women more than men. A study on medical students confirmed that smoking can be a precipitating factor for migraine attacks and the number of cigarettes smoked affected the development of migraine attacks.
Have you ever just gotten migraine pain from having a bad day? Stress is a predisposing factor to migraine attacks! Now the crazy thing is migraines can trigger stress, increasing migraine frequency. All you need to navigate this double-aged sword are proper stress management skills to respond better to stressors helping you manage migraines.
If you experience migraine attacks, you probably have a close relative who experiences them too.
Women of childbearing age are more likely to experience migraine attacks than men due to hormones.
Other factors that may trigger migraine attacks include:
- Change in sleep patterns/ lack of sleep
- Changes in weather (low altitude and wind)
- Skipping meals/starvation
- Strong scents
- Intense light
- Loud noises
- Medication use like oral contraceptives
- Dietary triggers like caffeine, sulfates, nitrates, and high-glycemic-index foods
The Genesis Of Ketones For Migraines
In the early 1920s, the keto diet was used to treat epilepsy in children. The diet initially introduced in the Hippocrates by Wilder showed that once adequate ketosis was achieved, hourly attacks of petit mal disappeared. When the clinical trials began, starvation was being used to maintain ketosis. A ketogenic diet was proven to be more effective and had more curative benefits than starvation.
Later, studies carried out provided increasing evidence suggesting that ketogenic diets improve migraine and other neurological disorders. A clinical trial on migraine patients reported that 39% of individuals reported a decrease in migraine attack frequency when on a keto diet.
There was a decline in the research on the effects of ketones for migraines due to the introduction of over-the-counter medication used to improve migraines.
A study on obese women with migraines was carried out to investigate the improvement of migraines during short-lasting ketogenesis. This interest in ketosis to manage migraines was triggered when a ketogenic diet performed for weight loss, led to the disappearance of migraines only when consuming a keto diet.
The study was on two groups of migraine patients, one on a very low-calorie keto diet for one month and then placed on a low-calorie diet (standard diet) for 5 months. The placebo-controlled group was placed on a standard diet for 6 months. The results reported a decrease in migraine frequency when on a keto diet but during the transition to the standard diet, the migraine frequency worsened although the headache intensity was improved.
The effects of ketones for migraines improvement are attributed to the ketogenic diet’s mechanism of enhancing mitochondrial energy metabolism and neuronal anti-inflammatory properties.
Another study on 18 migraine patients investigated if the changes in cerebral excitability on a keto diet were due to cerebral cortex activity or were modulated by the brain stem. The study’s evidence suggests that the cerebral cortex is the main site for keto diet modulation.
Underlying Mechanisms Of Ketones For Migraines
There are different causes of migraines, one of them being brain energy metabolism. What does this mean? Brain energy metabolism refers to the brain’s ability to get energy from our foods and convert it to fuel for the brain cells. A migraine is caused partly by reduced brain glucose metabolism leading to mitochondrial dysfunction. Your brain will function more efficiently if it is fueled by ketone bodies than glucose metabolism.
A keto diet triggers ketosis which is believed to reduce migraine frequency and severity by improving brain mitochondrial function, inhibiting neuronal excitability, compensating serotoninergic dysfunction, reducing calcitonin gene-related peptide (CGRP) levels, and improving cortical spreading depression (CSD).
Ketogenic Diet And Weight Loss
I know you are wondering, what is the relationship between your weight and migraine attacks? Obesity and headache pain including migraines can be related to each other through mechanisms like irregular hypothalamic function and inflammations.
A study performed over a period of 11 months to ascertain the causes of a chronic migraine in a population’s evidence suggests that obesity increased migraine frequency and the development of chronic migraines. Obese patients were five times more at risk of getting chronic daily headaches, while those who were overweight were three times more at risk than those with regular BMI.
Obesity is a risk factor for Idiopathic Intracranial Hypertension (IIH) which can lead to the development of migraine attacks. The concurrent rise in rates of obesity has led to the rise of IHS. A study on non-surgical interventions for weight loss showed that losing weight is an effective intervention to manage migraine headaches by reducing IIH.
A ketogenic diet promotes weight loss by promoting the burning of body fat to produce energy for the body. Going keto will lead to significant reductions in weight further reducing the migraine attack frequency.
Keto Diet And Metabolic Syndromes
People who suffer from migraine attacks and brain disorders have a high prevalence of insulin resistance, obesity, dyslipidemia, and hypertension, all components of metabolic syndrome. A review of metabolic syndrome and migraine pain suggested taking up a weight loss plan to manage migraine pain in individuals with metabolic syndrome.
Another study showed a higher migraine prevalence in patients with metabolic syndrome than in the general population. The evidence suggests that insulin resistance is associated with migraine pathogenesis.
Ketones increase cell insulin sensitivity, thus ketones for migraine is a feasible preventive treatment for migraine attacks.
Keto Diet And Hypoglycemia
People with mitochondrial disorders frequently experience hypoglycemia. Fasting/ skipping meals is one of the causes of hypoglycemia due to inadequate glucose availability and it triggers migraine pain.
Some symptoms of a migraine like dizziness, cognitive difficulties, sugar cravings, fatigue, and low blood pressure are present in hypoglycemia. Hypoglycemia can reduce brain excitability and mitochondrial function.
Ketone bodies can reverse the effects of hypoglycemia. D-Beta-hydroxybutyrate (D-BHB) is a naturally occurring ketone body produced by our bodies. Preliminary evidence shows that D-BHB prevents cortical neuronal death in hypoglycemic animals and stimulates ATP production in glucose-deprived cortical cells. When D-BHB is present in the blood due to ketosis, glucose production is reduced allowing for mitochondrial biogenesis. Mitochondrial biogenesis increases the number of mitochondria and promotes mitochondrial function.
Keto Diet And Anti-inflammation
Recent studies have been on the use of a keto diet to treat mild cognitive impairments like Alzheimer’s disease and Parkinson’s disease. Migraines are caused by brain inflammation which leads to brain energy deficit in people with chronic migraines. A keto diet can be used to manage migraine attacks because of its anti-inflammatory properties.
Ketone bodies have a scavenging capacity for reactive oxygen species (ROS) that cause oxidative stress in the brain causing cortical neuronal death. D-BHB reduces the production of ROS in the hippocampus. These anti-oxidant properties of ketones reduce oxidative stress and inflammation, further assisting with migraine prevention.
Keto Diet And Brain Energy Metabolism
Ketones have neuroprotective properties. Ketosis stimulates mitochondrial biogenesis leading to an increase in cellular energy reserves. Ketones are the brain’s preferred alternative fuel. On a keto diet, the brain can reduce the production of reactive oxygen species by increasing the mitochondrial loads and using a more energy-efficient alternative energy source.
Ketogenic Diet And Neuronal Excitability
A study on the effects of a keto diet on neuronal firing showed that ketones reduced firing in central neurons by opening the KATP channel. Ketones inhibit GABAergic neurons of the substantia nigra pars reticulata (SNr), the “gate” for seizures thus controlling seizures in epileptics.
Another study on mice with chronic migraines is caused by neuronal hyperexcitability. Increased excitability leads to the spread of depression in the brain, which on reaching a tipping point, triggers a migraine. Reducing neuronal hyperexcitability using ketosis will lead to migraine prevention.
Things To Consider For Migraine Prevention
A study done on obese patients suffering from migraine pain showed the beneficial effects of a low-calorie diet in migraine prevention. Atkins diet and keto diets trigger ketosis which can help you improve migraine by altering mitochondrial dysfunction, reducing oxidative stress, and cortical spreading depression.
The beneficial effects of keto diets in the prevention of a migraine attack are more distinct in children than adults because most adults find the diet too restrictive and more efficient in a less interactable population.
If sticking to a keto diet is proving difficult for you, you should consider ketone supplements. Due to potential side effects of ketosis like change in bowel movements and its contraindications in people with fat-metabolism disorders, an alternative to the keto diet is necessary that will allow us to improve migraine headaches.
Ketone supplements contain exogenous ketone bodies that increase blood ketone levels having the same beneficial effects as a keto diet. A study on the effects of exogenous ketones on the preventive treatment of migraine was carried out to investigate the efficacy and safety of using salts of exogenous ketones in migraine prevention. Ketone supplements can be an efficient alternative to a keto diet
Can Ketones Cause A Migraine?
On a keto diet, there is an energy deficit brought about by inadequate glucose, forcing your body to break down fats and use ketone as an energy source. This shift can cause fatigue, brain fog, and even headaches.
Keto headaches are a side effect of low-carb diets caused by hypoglycemia, dehydration, poor sleep, diuretics and some medication use. A keto headache can last a few days to a week depending on the individual. You can use acute medication to clear your keto headache. Other ways to help you prevent a migraine include:
- Staying hydrated
- Consume low-carb, water-rich foods like cucumbers, zucchini, and lettuce
- Use sea salt
- Consider electrolyte supplements
- Do not drink alcohol because it increases urination and leads to dehydration
Who Should Not Go Keto?
Despite the benefits of a keto diet, it is definitely not for everyone! People with certain health conditions and those with specific carbohydrate energy needs, more than that prescribed on a keto diet should avoid this diet.
Ketosis leads to the breakdown of body fat leading to weight loss. Underweight individuals have high carbohydrate energy needs since they require instant glucose for energy. If you are underweight refrain from a keto diet.
Eating disorders like anorexia can cause one to have food swings and not want to eat at all. A keto diet is restrictive and if not followed correctly, no desired results will be achieved. This can have some negative psychological effects on individuals with eating disorders.
Diabetics on insulin or blood sugar control medication should stay clear of a keto diet due to adverse side effects. Get approval from your doctor to start your keto journey while on medication.
As long as you follow the keto diet correctly, your body will achieve ketosis and help you prevent a migraine. You have to be consistent in following your ketogenic diet to maintain its preventive treatment of migraine.
Remember, stay hydrated, eat keto-friendly foods, and supplement your diet when necessary to reap the full benefits of going keto. We have delicious keto recipes that will make this journey worth your while too!
If you are starting a keto diet, observe the frequency and intensity of your migraine when beginning the diet and after you have been on the keto diet for a while. Do you notice any difference? Don’t forget to engage with us in the comment section with any questions you have on ketone for preventing migraine or any keto-related questions. Until next time, stay migraine-free with keto!