Ketogenic Diet for Migraine?
I started this blog many months ago as self-help for my migraines, and it has evolved into a blog about low-carb, with occasional migraine-related posts. If you want a little more detail about this evolution, check out my About the Migraineur page. If you want a lot more detail, read the archives. 
I have never claimed that there was any connection between migraine and a low-carb diet, but the thought has been nagging at the back of my mind. So many other health problems clear up when I limit grain, other starches, and sugars - what if migraine were another? What if I could get off Inderal, which has slowed, but not stopped, my weight loss?
Now, this new study from France has me wondering if low-carb could actually be a preventive measure for migraine. Warning: extremely technical language. If you’re not inclined to technical terms, (hey, I’m a bit of a nerd myself), try the layperson’s explanation on Jimmy Moore’s blog, where I originally found this.
Or, if even that’s too much, allow me to oversimplify even further. A ketogenic diet is one that reduces carbohydrates and replaces them with fat, thereby leading the body to produce ketones and burn them for energy. It’s long been known that a ketogenic diet can help control epilepsy in children - see this excellent article on Epilepsy Action’s website. According to the new study, the ketogenic diet works by changing the balance of two neurotransmitters, GABA and glutamate, in the brain. On a ketogenic diet, GABA increases, and glutamate decreases. This is because burning glucose causes the body to make more glutamate, and burning fat causes the body to make less.
Call me gobsmacked.
GABA may not mean anything to the average migraineur, but anyone who has ever suffered from migraine should be very familiar with glutamate. Glutamates in all their forms (mushrooms, parmesan cheese, soy products, MSG and its kin) show up frequently on lists of common migraine food triggers. What I did not know what that glutamate acts as an excitatory neurotransmitter, which just means it causes neurotransmitters to fire. I also didn’t know that glutamate is actually produced by our bodies, and I didn’t know that it often occurs in inverse ration to GABA, which is a neurotransmitter that inhibits the firing of neurons.
This suggests (but does not prove) that you can spend all the time you want avoiding all those glutamate-rich foods, but as along as you are feeding your brain a steady supply of glucose, it’s just gonna keep cranking out glutamate on its own.
Also note that one commonly prescribed migraine preventive is Topamax - an anti-seizure drug. This also suggests (but does not prove) that treatments that are effective for epilepsy may also be effective for migraine.
Things it would be nice to know:
1. How much glutamate occurs in the brain on the 300 g of carb a day recommended by the USDA?
2. How much glutamate occurs in the brain on the 20 g to 50 g of carb a day recommended by many low-carb diet plans?
3. How do these numbers compare to the glutamate in a reasonable-sized serving of Parmesan cheese or mushrooms?
4. When is someone going to do a study of the effect of a ketogenic diet on migraine? (Geez, I wish I were a scientist right now …)
Still, I find this very exciting - it really would be nice to get off Inderal!
Migraine aura picture from 
Hello,
there is a very interesting site in German about ketogenic diet and migraine treatment. The guy maintaning the site treats succesfully migraines for years with a ketogenic approach.
He developped his theory by himself and was often attacked and ridiculed even in low-carb fora, but this new study, shows exactly what he told years ago.
http://www.miginfo.de/molmain/main.php?sites_index=1
Comment by gallier2 — October 25, 2007 @ 12:32 pm
psipsina, go visit http://george-eby-research.com . It seems that magnesium deficiency plays a large role in migraines.
Comment by LCforevah — October 25, 2007 @ 1:13 pm
psipsina,
Dr. Larry McCleary, who explained the ketonic diet-seizure study, has just published a book on his findings concerning ketonic diets: The Brain Trust Program: A Scientifically Based Three-Part Plan to Improve Memory, Elevate Mood, Enhance Attention, Alleviate Migraine and Menopausal Symptoms, and Boost Mental Energy.
He has started a blog, also:
http://www.drmccleary.com/
Hopes this helps you.
Sue
Comment by Sue — October 25, 2007 @ 1:50 pm
Gallier, Sue - thanks for the links. I wonder how the Google translation tool with do with the auf deutsch site.
LCforevah - thanks for your comments, too. Three months of supplementing with 500 mg of magnesium did nothing for me. I keep meaning to look up the study or studies behind this to see if they were randomized double-blind clinical trials or population studies, or what.
Comment by psipsina — October 25, 2007 @ 5:31 pm
Heard of the The Glutamate/ Aspartate Restricted Diet *(G.A.R.D.)?
http://dogtorj.tripod.com/id16.html
I do know of someone who has had migraines triggered by aspartame and so tries to avoid it.
Comment by nonegiven — October 26, 2007 @ 1:55 pm
Very interesting. I had undiagnozable extremely severe headaches for 23 years that have been lafgely cured by eliminating wheat gluten from my diet. I had tried it before and thought it didn’t work, but had not realized that it would take between 45-60 days for it to really kick in. Now that I’m “gluten clean” (for lack of a better phrase) I can eat limited amounts of wheat with minimal trouble.
I think we are insufficiently aware of the impact our diets have on our health, especially considering the ways in which food is processed/preserved,and the different environmental impacts even on organic products.
Comment by davidrochester — October 27, 2007 @ 2:01 am
Whoops, that should say “undiagnoSable” — typing without my contact lenses in is never a good idea.
Comment by davidrochester — October 27, 2007 @ 2:01 am
When my husband and I started low carb eating in 2004, we had no idea that there would be benefits other than weight loss. But after some time, I realized my husband hadn’t asked me to get more Alka-Seltzer (I used to buy it in warehouse sized boxes for him). He just didn’t get heartburn any more. At all. Both of us noticed remarkably less gas, too.
Then I realized that we still had the huge bottle of ibuprofen and it was close to expiring before being emptied. That was a first. I asked my husband about it and he said he just wasn’t getting headaches regularly anymore.
So we don’t know whether it was carbs in general or specifically wheat or gluten that caused those problems, but either way, we are better off. So I don’t doubt that there could be other benefits to conditions such as migraines when carbs are limited.
Comment by Anna — October 28, 2007 @ 1:40 pm
Anna - I have so much gas and other lower GI ickiness on a high-carb diet that I have actually been tested for celiac. (And I apologize to those who will think this is Too Much Information, but the high-carb gas is much smellier than the low-carb gas.) Unfortunately, the doctor didn’t think to tell me that if I hadn’t been actually eating grain, I wouldn’t be producing the celiac antibody. The test came back negative, but I’m not convinced that I don’t have celiac.
David - I used to wonder if low-carb would be good for headaches because it naturally limits gluten (unless you eat a lot of vegetarian gluten protein as a meat substitute). But after seeing this study, I truly wonder if there is more going on. I’m going to keep looking into this.
Comment by psipsina — October 29, 2007 @ 1:52 pm
It’s interesting to me that you’re thinking along these lines because my primary care physician has encouraged me to try a gluten-free diet. I don’t know if that’s exactly the same (I need to do more reading), but it sounds similar. I think I’m going to have to bite the bullet and give gluten-free eating a try. Scary!
Comment by Diana — October 29, 2007 @ 11:33 pm
FYI — One thing that is insufficiently stressed about going gluten-free is that you will have an extremely physically stressful withdrawal period. Mine wasn’t too bad because I knew this, from having tried to do it in the past, so I tapered off gradually, which was much easier on my body … as with any kind of “addiction,” going off gluten initially feels like the wrong thing to do.
But once you’re off, the cravings for it will go away after a couple of weeks. The other wonderful thing is that if you’re limiting gluten, you will end up also cutting a lot of sugar out of your diet, almost by default, which can also work wonders for headache issues.
Comment by davidrochester — October 30, 2007 @ 11:14 am
Wow! That little drawing of the aura is exactly what mine look like! It’s always been hard for me to describe it to someone but there it is! Thanks!
Comment by Violet — October 30, 2007 @ 8:26 pm
Unfortunately for me low-carb dieting has not helped reduce the frequency or severity of my migraine headaches. Magnesium has many benefits besides helping some people reduce migraines as it is a mineral used in many of the body’s processes. At higher doses it is very good for the digestive system, and it can help the nervous system recover from strenuous workouts. However it must be taken separately from your calcium supplements as the calcium competes for absorption (and wins). Many calcium supplements contain magnesium but it’s not a good idea to take these together. It’s best to take it at night just before bedtime with your zinc and B6. I’m glad you’re finding information that can help people and I’m enjoying reading your blog.
Comment by virg — December 5, 2007 @ 10:45 am
[...] by your health insurance. Finally, it seems like a relatively safe treatment to try. And as I wrote several weeks ago, there are some reasons to think that it might make sense. For one thing, McCleary stresses that [...]
Pingback by Recommended Reading 3: The Brain Trust « The Migraineur — December 10, 2007 @ 9:07 am
Just wanted to say thanks for confirming what I’m finding out. I “normally” have 4-6 migraines a week. I started on a low-carb diet recently just to lose about 15 lbs (you know, because the headaches weren’t torture enough– I needed to torture myself with food too.) After the first day on the diet, I have not had ONE migraine. I wondered if there was a correlation and when I “googled” it, I found your blog.
Thanks for letting me know I’m not crazy! Looking forward to perusing more of your blog.
Comment by Reformed Grits — January 8, 2008 @ 4:07 pm
Everytime I start a low calorie diet I get headaches as well, I guess not as painful as a migraine, but still, really anonying.
Comment by Negative calorie — January 13, 2008 @ 7:37 pm
Question about the magnesium not working for you: I’ve heard that some forms of magnesium are just about worthless in terms of absorbability. Did you experiment with different forms or just try one or two?
I find I have to have some caffeine in my diet every day or I have migraines. Literally, it seems to have a prophylactic effect. However, that was while eating high-carb. I haven’t been able (willing?) to stick with low-carb for long enough to feel comfortable giving up caffeine as well, to see if the latter has any effect where my headaches are concerned.
Comment by Dana — February 13, 2008 @ 5:14 pm
Hi, Dana,
At the time, I didn’t know one magnesium from the other, so of course like most people I bought the cheap magnesium oxide. I’m now taking magnesium malate, which is supposed to be better. I never gave up the magnesium because it’s supposed to have all kinds of good effects, and it’s really hard to get the RDA from food. But I attribute my 8 migraine-free months to Inderal, and I’m a little too chicken to stop it and see if low-carb really keeps everything under control.
Regarding caffeine and low-carb, I’m a big believer in one thing at a time. I think low-carb has such dramatic results for most people who can stick to it for just two short weeks, that anything else you can do to improve your health is just tweaking.
Comment by psipsina — February 13, 2008 @ 6:27 pm
The first time I went on the low-carb diet it was to hard for me and I could not stick to it long enough to see any results. I started again about three weeks ago and it is amazing. My migraines have completley gone away, along with some weight and the cravings. I will admit the cravings was the hardest part but after seeing results on the second day of the diet it was well worth it. Now I am migraine free.
Thanks for the great post!
Comment by Headache Help — February 16, 2008 @ 1:22 am
Re:Glutamates/Excitotoxins
A ketogenic diet is an interesting approach. (It might help reduce carb cravings by adding cream of tartar and chicory inulin to your diet. Tartar & FOS will help reduce the beastie yeasties that crave sugar carbs.)
Excitotoxins such as aspartame & msg trigger a vigorous glutamate response. Cutting back or completely eliminating packaged and canned foods will significantly reduce glutamate exposure. Most of my friends reduce their exposure by staying away from non-dairy creamers and artificial sweeteners that are common in soft drinks. Unfortunately, most low-carb packaged foods are FULL of sugar or artificial sweeteners~
What about glutamate inhibitors? Two of the easiest inhibitors to use are theanine (tea) and magnesium malate or magnesium citrate. It might be worthwhile to do a websearch of glutamate inhibitors, excitotoxins and supplements that are neuroprotective.
Comment by Tommy Thompson — February 27, 2008 @ 12:33 am
[...] in spite of my neglect of the topic of migraine, far and away the most viewed post on my blog is Ketogenic Diet for Migraine? And, in fact, if you Google “ketogenic diet migraine,” my blog is the first hit. [...]
Pingback by Be Careful What You Name Your Blog « The Migraineur — March 28, 2008 @ 9:05 pm
I was getting migraines about once a week before I started a low-carb diet. I didn’t know that it would take care of my headaches until I realized that I hadn’t had one since about two weeks after I started. Now, I’ve realized that whenever I take a day off and eat a lot of carbs that I can count on being in bed all the next day with a migraine. Maybe low-carb dieting isn’t as silly as people think.
Comment by Leah — March 30, 2008 @ 4:43 pm
My mother is a chronic migraine sufferer and is hypoglycemic. I have a classic migraine every once in a while, but only recently learned that something else that I’ve always experienced (Scotomas) are considered to be a type of migraine (Optical Migraines).
I found that my severe reactions to going too long without eating were due to hypoglycemia. I did some research and put things together. Hypoglycemia causes seizures and scotomas. A ketogenic diet controls hypoglycemia and epileptic seizures. Perhaps ketosis can treat classic migraines too? Maybe there is a link.
I have been able to avoid the optical migraines for quite some time by staying hydrated and not allowing myself to get too hungry. Before I understood the effects of carbohydrates I had a meltdown once or twice a week. When I eat a ketogenic diet, I have no symptoms at all; and can go for long periods of time without scotomas or any other ill effects.
Thanks for this blog. I hope more research is done on this topic.
Comment by Roxanne — April 22, 2008 @ 7:13 pm