How to Treat Migraine by Ketogenic Diet?
The ketogenic diet prevent migraines better than drugs commonly used in prevention. Explanations.
Migraines are closely related to diet. This is what causes sufferers to avoid (at choice) sulphites, old cheeses, certain alcohols, sugar, dairy products, gluten … with more or less effect on the number of crises. In recent years, a new nutritional approach is emerging for migraine sufferers: the adoption of a ketogenic diet. Since 1920, the ketogenic diet has been used successfully to treat epileptic children who do not respond to drug treatment. The ketogenic diet is a diet very low in carbohydrates (and high in fat) that encourages the body to metabolize ketones. These molecules can also be synthesized (by the liver) following the ingestion of medium chain triglycerides (or MCTs, found for example in coconut oil) and serve as an alternative fuel to carbohydrates in the body.
For neurologists, there are indeed similarities between migraines and epileptic seizures:
- Both occur episodically.
- Both reflect temporary changes in the brain, often with localized neurochemical disruption.
- Both are triggered by almost the same factors: stress, disruption of sleep / wake cycles, use of stimulants or sedatives.
- Both are often suppressed with medications that soothe “overactive” brain cells.
Hence the idea of preventing migraines with this diet. The trials are promising: as Dr. Elisabeth Leroux, a specialist in migraine, says, ” the ketogenic diet has been studied in migraine patients with some success “. In 2013, an Italian study showed that a ketogenic diet reduced the incidence of migraines in 90% of patients followed (1). A success that overshadows that of drugs usually prescribed to prevent migraines. In 2017, an Italian study reviewed all intervention studies regarding the effects of a ketogenic or very low carbohydrate diet (such as Atkins) on migraines. Of the 7 studies selected, 6 showed that the ketogenic diet was effective in reducing the frequency and intensity of migraines, and sometimes to make them disappear completely. In most cases, the ketogenic diet began to be effective in just a few days (2).
There is still a lack of large-scale studies to confirm these results and especially to establish the optimal duration (and frequency) of a ketogenic diet for migraine sufferers. But in the meantime there is nothing to lose trying to eat ketogenic to reduce the crises, or even make them disappear.
How do ketones work?
There are several ways to explain the effects of ketone bodies and the ketogenic diet on migraines:
– Ketones block high concentrations of glutamate in the brain, a phenomenon found both in migraine and epileptics (3).
– Eating ketogenic also implies no longer ingesting industrial foods (or at least drastically reduce their consumption). The latter are the main suppliers of ingredients that trigger migraines.
– Another explanation for the anti-migraine effects of ketones is related to fats, very present in the ketogenic diet. They would help produce vitamin D and especially serotonin, a high level of vitamin D or serotonin protecting migraines (4).
– Hunger is a big factor of migraine. Eating ketogenic satiates better and longer, avoiding cravings and therefore migraines.
– Most triggers of migraine have recently been associated with oxidative stress (5). To the point that the next anti-migraine drugs target a peptide released by oxidative stress (6). Ketones reduce the level of oxidative stress, perhaps acting directly on the origin of the disease (7).
It would also appear that ketone bodies have a protective effect on cell damage. Experiments have shown that ketone bodies protect brain cells from oxidative and destructive lesions (8). This type of free radical damage is thought to play a major role in several degenerative brain pathologies, including Alzheimer’s and Parkinson’s diseases.
Mental fog, brain damage, markers of oxidative stress … migraine patients clearly have trouble turning glucose into energy. Using ketones to provide energy to the brain seems very logical. Especially as the author of ” Ending Migraine ,” Dr. Turknett points out, “migraines do not spread easily in the brain when ketones are the main fuel”. It has also been shown that simply adding coconut oil to one’s diet can produce ketones and have positive effects on the brain (such as the disappearance of mental fog).
The ketogenic diet requires great rigor and is not easy to implement alone, we advise you to speak to a dietician who knows him or a nutritionist before you start. Note that the new Atkins diet also allows, in its attack phase to go into a state of ketosis.
(1) C Di Lorenzo, G Coppola, G Sirianni, F Pierelli : Short term improvement of migraine headaches during ketogenic diet: a prospective observational study in a dietician clinical setting. J Headache Pain. 2013; 14(Suppl 1): P219.
(2) Barbanti p, Fofi L, Aurilia C, Egeo G, Caprio M : Ketogenic diet in migraine: rationale, findings and perspectives. Neurol Sci (2017) 38 (Suppl 1):S111-S115.
(3) Marwan Maalouf, Patrick G. Sullivan, Laurie Davis, Do Young Kim, and Jong M. Rho : Ketones inhibit mitochondrial production of reactive oxygen species production following glutamate excitotoxicity by increasing nadh oxidation. Neuroscience. 2007 Mar 2; 145(1): 256–264.
(4) Patrick RP, Ames BN : Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015 Jun;29(6):2207-22. doi: 10.1096/fj.14-268342. Epub 2015 Feb 24.
(5) Borkum JM : Migraine Triggers and Oxidative Stress: A Narrative Review and Synthesis. Headache, Volume 56, Issue 1 January 2016 Pages 12–35.
(6) S Benemei, C Fusi, Gabriela Trevisan, Pierangelo Geppetti : The TRPA1 channel in migraine mechanism and treatment. Br J Pharmacol. 2014 May; 171(10): 2552–2567.
(7) Julie B. Milder, Manisha Patel : Modulation of oxidative stress and mitochondrial function by the ketogenic diet. Epilepsy Res. 2012 Jul; 100(3): 295–303.
(8) Maalouf M, Rho JM, Mattson MP : The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain Res Rev. 2009 Mar;59(2):293-315. doi: 10.1016/j.brainresrev.2008.09.002. Epub 2008 Sep 25.