Can Cutting Carbs Cure Migraine Misery?

Migraines affect over 10 million people in the UK alone. Most migraine sufferers may experience changes in their work capacity and social activities because of the debilitating nature of migraine headaches. Triggers vary from person to person and there is no clear way to avoid all triggers. One factor that influences migraine is diet.

Most often, nutritional interventions for migraines include taking supplements such as magnesium, riboflavin, coQ10, or natural herbs.

Research shows that one’s diet contributes to the overall risk of migraines. Experts are looking into diet modification for extreme migraine sufferers. Shifting to low-carbohydrate ketogenic diets have shown to reduce migraine headaches in several studies. Reducing carbohydrates have been used in treating children with epilepsy.

In Italy, experts tested volunteers on a low-carb, high-fat diet which forces the body to burn fats instead of carbohydrates. Within the first month of the change in diet, volunteers found that their migraine attacks were significantly reduced.

How does it happen?

Apparently, if you reduce carbs intake, your body produces ketone bodies for its fuel. These are water-soluble molecules that are less demanding and less inflammatory compared to the glucose that is normally produced. Experts believe that this could be the reason why there’s a significant reduction in migraines when you cut down carbs.

In severe cases, migraines can interfere with daily activities and may require hospitalization. Migraines are thought to be caused by a combination of genetic and environmental factors.

According to lead researcher Cherubino di Lorenzo from the University of Rome told Danielle Bengsch at ResearchGate.

"Our hypothesis is that the combination of ketone bodies and changed glucose response could lead to the outstanding therapeutic effect we have observed in our patients.”

Why do sugar and carbs cause headaches?

Did you ever enjoy eating a slice of cake and had a headache after? Most people with migraines have reported that foods high in refined carbohydrates or sugar triggers migraines.

In a review of studies published in 2018, it was found that 30% of patients reported that eating habits or foods triggered their headaches. But, according to new studies, experts suggest that migraines cause people to eat foods that are high in sugar or carbs.

During the first stage of migraine attacks people may experience brain fog, fatigue, light sensitivity, mood changes, increased urination, and muscle stiffness. Brain imaging studies also showed that during the initial stage of migraine attack, the region of the brain that regulates hunger called the hypothalamus, is activated, which causes people to crave and eat certain foods. Shortly after indulging their cravings, the headache phase begins—this makes people wonder that what they ate contributed to the pain they are feeling.

According to Dr. Goadsby

“It is pretty clear that this area is changing in its activity before the pain starts. What a person reaches for in response is often carbohydrate-rich and highly palatable, though the exact food varies from person to person. Some people want savoury or salty snacks, while others crave sweets and chocolate.”

There are some pieces of evidence to suggest that cutting carbs   - may be effective in reducing the frequency and severity of migraines.

The exact mechanism by which carbs help is not fully understood, but it is thought to work through a number of different pathways. For example, it may work by improving the gut biome, increasing ketone bodies or by reblancing the gut bacteria so new nutrients can be made.

What is the Ketogenic diet?

Ketogenic is a term used for low-carb diets. The main idea is to get more calories from protein and fat and less from carbohydrates. Most people who try ketogenic diets have almost zero carbs. They cut back on carbohydrates that are easy to digest such as soda, sugar, white bread, and pastries.

When you start a ketogenic diet and eat less than 50 grams of carbs per day, your body will run out of fuel (blood sugar) it can use quickly. You’ll start breaking down protein and fat for energy, which makes you effectively lose weight. This is called ketosis.

It is important to note that this type of diet is short-term and is focused on weight loss rather than pursuit of health benefits.

Other than weight loss, people use a ketogenic diet to manage certain medical conditions like heart disease, epilepsy, certain brain disease, and more. It may also help with other nervous system disorders including Alzheimer’s disease, Parkinson’s disease, and sleep disorders. Scientists are baffled, but they believe that the ketones on the body when it breaks down fat for energy helps protect your brain cells from damage.

Should you try Ketogenic diet to help reduce migraine?

It is true to say that many conventional medical doctors and practitioners are not keen on the ketogenic diet - In fact they often suggest having smaller, more frequent meals. However, there are many commentators and experts who disagree and suggest that ketogenic diets are very helpful for not only migraines but other neurological conditions like epilepsy and Parkinson's Disease.

If you are struggling with your migraine headaches it may be worth examining the pros and cons of undertaking a ketogenic regime in order to try it out. It should be noted that most practitioners note that on ketogenic diets there are a few days of changing difficulty when beginning them because the body is not used to the massive change in the type of nutrition. This is often called “keto flu”. However, anecdotally supplements like glutamine can be taken to reduce any such side effects and the reader is advised to look at forums and other places to see whether the ketogenic diet can be helpful in your migraine therapy.

Along with some nutritional approaches, for example, taking riboflavin 400 mg has been shown scientifically to help reduce migraine frequency.

Different type of Ketogenic diet

There are several versions of the Ketogenic diet, including:

  • Standard ketogenic diet
  • Cyclical ketogenic diet
  • Targeted ketogenic diet
  • High protein ketogenic diet

However, only the standard and high protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods and primarily used by bodybuilders or athletes.

The information in this article mostly applies to the standard ketogenic diet (SKD), although many of the same principles also apply to the other versions.

Ketones may prevent migraine attacks

Ketone bodies provide your brain and body with more energy than glucose—which means the brain and the muscles are working more efficiently. People with migraines often experience energy shortage, that’s why ketones are very important for them.

We also know that migraine headaches are associated with inflammation. Based on studies, applying a ketogenic diet has shown anti-inflammatory effects on the body.

What are the risks associated with a Ketogenic diet for migraines?

Many health care researchers and organisations have recognized the risk of ketogenic diet. It could cause kidney stones, low blood pressure, nutrients deficiencies, increased risk of heart disease, and constipation. Studies also showed that strict diets like keto can result in eating disorders or social isolation.

It is important to note that a ketogenic diet is not recommended for people with conditions involving their liver, pancreas, gallbladder, or thyroid.

Ketogenic diet is highly recommended to be done under the supervision of your healthcare specialist to prevent nutritional deficiencies.

Further reading

Pfeiffer, A.F., Zeng, L., Thompson, J. et al. A low-carbohydrate diet is effective for the management of migraines. J Headache Pain 12, 85 (2011).

Paoli, A., Rubini, A., Volek, J.S., Grimaldi, K.A. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr 67, 789-796 (2013).

Liu, Y., Liu, J., Tan, L. et al. Low-carbohydrate diet in the management of migraines. Nutrition 29, 1150-1153 (2013).

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