Migraine, headache: the benefits of the ketogenic diet

The ketogenic diet helps prevent migraines better than drugs commonly used in prevention. Explanations.

Migraine: patients who tend to avoid certain foods

Even if there are other environmental risk factors (noise, stress …), migraines have a close link with the diet. This is what leads people who suffer to avoid (your choice) sulfites, 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 has been emerging for migrainers: the adoption of a diet of a ketogenic type.

Migraine: why avoid sugar and carbohydrates

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 very poor diet in carbohydrates (and rich in fats) which encourages the body to metabolize ketones. These molecules can also be synthesized (by the liver) following the ingestion of medium chain triglycerides (or TCM, found for example in coconut oil) and serve as alternative fuel to carbohydrates to the body.

For neurologists, there are indeed similarities between migraines and epileptic crises.

The two occur episodically.
Both reflect temporary changes in the brain, often with a localized neurochemical disturbance.
The two are triggered by almost the same factors: stress, disturbance of the watch/sleep cycles, use of stimulants or sedatives.
Both are often removed thanks to drugs that calm “hyperactive” brain cells.

Hence the idea of preventing migraines with this diet poor in carbohydrates. Besides, in his book End the migraineDr. Turknett recommends avoiding added sugars and sweet fruits in his diet.

The ketogenic diet, a remedy for migraine?

The tests are promising. Thus, in 2013, an Italian study showed that a ketogenic diet made it possible to reduce the frequency of migraines in 90 % of patients followed (1). A success that eclipses that of the drugs usually prescribed to prevent migraines. In 2017, an Italian study reviewed all intervention studies concerning the effects of an ketogenic or very low carbohydrate diet (like 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 was starting to be effective in just a few days (2).

There is still a lack of large -scale studies to confirm these results and above all establish what is the optimal duration (and frequency) of an ketogenic diet for migraine. But in the meantime there is nothing to lose trying to eat ketogen to reduce crises, or even make them disappear.

Can you have a headache during a Keto diet?

When you embark on a ketogenic diet, for example for weight loss or to improve your well-being, there is a transitional period, before entering the ketosis phase, during which unpleasant symptoms are possible: this is called ketogen. “This state is caused by an electrolyte imbalance (sodium, magnesium, potassium, calcium, phosphate) and by changing the fuel of the cells (they must get used to it) when the body enters ketosis”explains the dietician-nutritionist Magali Walkowicz in The Keto diet from A to Z.

Transitional symptoms appear on days following the start of the diet and are varied, more or less intense and are in the form of digestive disorders, but also headaches, dizziness, concentration disorders … “This phenomenon is a passengersaid Magali Walkowicz. Although unpleasant, it is positive because it indicates that the process is engaged. Symptoms are generally more intense during the first week and disappear after 10 days. “

How do ketones act?

There are several tracks to explain the effects of ketone bodies and the ketogenic diet on migraines.

Ketones would block the high concentrations of glutamate In the brain, a phenomenon found both in migrainers and epileptics (3).
Eating ketogen also implies that he no longer ingestsindustrial foods (or at least radically decrease their consumption). However, these are the main providers of migraine trigger ingredients.
Another explanation for the anti -migraine effects of ketones is linked to fatvery present in the ketogenic diet. They would help produce vitamin D and especially serotonin, a high rate of vitamin D or serotonin protecting migraines (4).

Headache: favor omega-3 fatty acids

A diet rich in omega-3 fatty acids (fatty fish, nuts, chia seeds …) and poor in omega-6 (sunflower oils, corn, grape seeds) reduces the frequency and intensity of headaches (5). This is the result of a randomized study on 122 people subject to headaches. For 12 weeks, they followed either a diet rich in omega-3 and poor in linoleic acid (omega-6), or a control diet. Compared to witnesses, the intervention group has significantly reduced the number of days of headache (-2 days per month) and their average intensity.

There hunger is a large migraine factor. Eat ketogenous satisfies better and longer, avoiding cravings and therefore migraines.
Most migraine triggers have been associated with oxidative stress (6). To the point that the next anti-migraine drugs target a peptide released by oxidizing stress (7). Ketones make it possible to reduce the level of oxidizing stress, thus perhaps acting directly on the origin of the evil (8).
It would also seem that ketone bodies have a protective effect of cell lesions. Experiments have shown that ketone bodies protect brain cells from oxidative and destructive lesions (9). It is believed that this kind of damage due to free radicals plays a major role in several degenerative pathologies of the brain, including Alzheimer’s and Parkinson diseases.
Another explanatory track: ketones seem to improve the functioning of mitochondria, The energy power plants of our cells. However, several studies suggest that migraine could be linked to a dysfunction of mitochondria: migraineous are more numerous in groups of patients suffering from diseases due to a dysfunction of mitochondria, migraine seems to have a hereditary component via chromosome x, or mitochondrial DNA comes from the mother. In addition, the majority of nutrients to help prevent migraines can be linked directly to energy metabolism or to the functioning of mitochondria: vitamin B2, coenzyme Q10, alpha-lipoic acid, magnesium … (10).
The intestine-end axis could also play a role even if it is still little known. Studies have indeed reported that migrainents suffer more than the rest of the population of symptoms or gastrointestinal disorders. The link between these disorders and the migraines could have to do with inflammatory mechanisms and an alteration of the Intestinal microbiota. Studies on epileptic children following an ketogenic diet also indicate that this diet has a positive effect on their intestinal microbiota (11).

What to eat when you have a headache? Anti-migraine foods

Mental fog, brain lesions, oxidizing stress markers … Migrainests clearly have trouble transforming glucose into energy. Using ketones to provide energy to the brain therefore seems very logical. Especially as the author ofEnd the migraineDr. Turknett, ” Migraines do not easily propagate in the brain when ketone bodies are the main fuel ». It has also been shown that simply adding coconut oil to its diet made it possible to produce ketones and obtain positive effects in the cerebral level (such as the disappearance of mental fog).

Read: migraine and food: those who trigger it, those who warn it

The ketogenic diet requires great rigor and is not easy to set up alone, we advise you to contact a dietitian (e) who knows him well or a nutritionist doctor before you start. Note that The new Atkins diet Also allows, in its attack phase to go into a state of ketosis.

Is coffee good for migraine?

The question of the relationship between coffee and migraine is controversial. Some people think that coffee promotes migraine, others that it is a remedy for migraine … Many studies have looked into this subject. In 2020, Polish researchers tried to elucidate the question in an article published in the journal Nutrients (12). According to them, “Drinking coffee before a migraine crisis may not be a real headache trigger, but rather a consequence of premonitory symptoms, including yawns, drop in energy and drowsiness, which can announce a headache.”

To find out what was the influence of caffeine on headaches, they selected 28 studies examining this relationship. Result : “All studies on treatment have concluded that caffeine was safe and effective in the treatment of acute migraine, mainly in combination with other pain relievers”. The authors conclude: “Overall, according to our analysis of the current literature, evidence is insufficient to recommend caffeine stopping all migraine patients, but it should be noted that excessive caffeine consumption can lead to a chronicization of migraine and that sudden withdrawal of caffeine can trigger migraine crises.”

Migraine: Should we avoid gluten?

Doctor Turknett, former migraine and author of the book End the migrainenoted the beneficial effect of a sugar and gluten -free diet on its own migraines. If only 1 % of the population suffers from gluten intolerance (celiac disease), a much greater part is concerned by the sensitivity of gluten. “These people sensitive to gluten can suffer for years, if not all their life, of a multitude of unexplained symptoms “, he said. This is rule n ° 1 of the diet he advocates in his book: eliminate all foods containing gluten (wheat, barley and rye) and added sugar.

In other people, it is the eviction of dairy products that can be beneficial. It is up to everyone to test and have their own experience by removing the foods that seem suspect, then observing the effects of this eviction on their body.