The Migraineur

December 10, 2007

Recommended Reading 3: The Brain Trust

Both in my Comments section and in the comments on other blogs, cyberpals and strangers have been telling me that Dr. Larry McCleary’s book, The Brain Trust, recommends a ketogenic diet for migraine. I have had it on hold at the library, and I finally finished it last week.

If you read my blog because you are a migraine sufferer, please read this book. If you read this blog because you are a devoted low-carber, you will find yet more confirmation of the health benefits of the low-carb lifestyle for everyone, not just people who need help managing their weight. And if you read the blog because you are interested in low-carb, but wary, or if you stumbled onto this entry because you googled “Alzheimer’s” or “Parkinson’s,” please also read this book.

I’d particularly like to address myself to my migraine friends, but before I do, let me make some general comments. If you are a long-time fan of low-carb, you know that skipping the bread, pasta, rice, potatoes, and dessert leads to weight loss, stable blood sugar, improved lipids, and rapidly normalized blood pressure. If you are like me, you also suspect that you’re doing good things for the rest of your body – your joints may have stopped aching, your acid reflux may have improved, your acne may have cleared up, your PMS may be less severe – heck, I am convinced that low-carb is responsible for the near disappearance of my carpal tunnel. (Actually, what I’m convinced of is that it wasn’t carpal tunnel at all, but hyperglycemia-related neuropathy.) And, of course, you may have noticed that your mood has improved and your after-lunch brain fog has disappeared. Again, if you’re like me, you may know some people who, although not overweight, might benefit from skipping their daily Coke to clear up some nagging health problems, but have the false perception that low-carb is just for weight loss. If so, please ask them to read this book – McCleary’s recommended diet to prevent the gradual cognitive decline that so many of us think is inevitable looks very much like the maintenance phases of the Atkins and Protein Power diets.

And now, for my migraine friends: if you don’t want to read the whole book, please at least read the chapter on migraine. I know that migraine is a complex disease, or series of diseases, and after a year spent combing the interwebs for every scrap of information I could find, I know that what works for some people fails miserably for others. I also know that there are many lifelong migraine sufferers who have tried everything from pharmaceuticals to biofeedback to elimination diets to Chinese herbal medicine. And I also know my blog is heavily biased in favor of low-carb, because low-carb has bestowed so many general health benefits on me. Having said all that, the reason I am so excited about McCleary’s migraine prevention plan is that I have never seen anyone explicitly recommend a ketogenic diet for migraine before. So, if you feel you’ve tried everything, this kind of intervention may be news to you. And while a ketogenic diet can be somewhat more expensive than the standard American grain-based diet, it is less expensive than pharmaceuticals, and it is certainly less expensive than alternative therapies that are not covered 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 periods of low-blood sugar can cause migraines, and that rings true to me because many people, me included, find that skipping meals, especially breakfast, can trigger migraine. (In fact, skipping meals and losing sleep are the only two things that reliably triggered migraines for me, pre-Inderal.) McCleary’s argument is that a ketogenic diet bypasses the blood sugar cycle altogether by offering the brain ketones as an alternative fuel source.

One note: one of McCleary’s recommendations for migraineurs is an MCT (medium-chain triglyceride) supplement. This seems unnecessarily expensive to me. Coconut oil is about 60% medium-chain fatty acids, is cheaper, and can be used in cooking and baking. So you could replace a couple of tablespoons of other fats in your diet with coconut oil, and probably get the same benefit.

The book does have its shortcomings. It’s not a lengthy volume, and several pages in the center of the book are occupied with little exercises you can do to test and improve your cognitive abilities, which makes the book even shorter than it appears. I sometimes feel that, because of the brevity of the book, McCleary sacrifices details that could help make his case. When discussing the use of ketogenic diet, he does not describe in great detail exactly how one does such a diet (check out Dr. Atkins’ New Diet Revolution or Protein Power if you need details), and he doesn’t address the health concerns that many people in today’s fat phobic world will have. Furthermore, he doesn’t say whether the ketogenic diet should be adhered to indefinitely, or whether one should stick to it for several weeks and then go back to his ordinary recommended diet. And for those of us who are low-carb fans and know the almost magical weight-loss effects of ketosis, it would be nice if he gave some guidance on how exactly a normal weight person avoids weight loss on a ketogenic diet.

Disclosure: Perigee Trade, the publisher of The Brain Trust, is owned by the same company that owns the company where I work. Please note, however, that even if every single one of my 100 or so daily readers bought a copy of that book, and persuaded two other people to buy it, too, the total effect on the value of my company’s stock would be nil. Seriously.

10 Comments »

  1. First, according to Bernstein (page 25 under ‘Diseases Affecting the Tendons’)
    http://www.diabetes-book.com/articles/bernstein.pdf
    carpal tunnel is a common complication of sustained high blood sugars (glycosylation of collagen in the tendons.) It just isn’t commonly known by doctors or anyone else. I have heard CTS mentioned as a risk factor for diabetes, though.

    Second, a ketogenic diet will add weight to a person who is too thin so I don’t think too much weight loss would be a big problem in the long run. It is healthy, not magic. It will often reconfigure a person’s body composition by helping to take off fat and add muscle. Many people have noticed their dress size or waist measurement getting smaller even when they aren’t seeing any movement on the scale. Kelly Bliss, a very large HAES (health at every size) and SA (size acceptance) advocate mentioned she eats a ‘high fat’ diet to help control seizures, so it probably won’t turn _all_ fat people into skinny people or she would be a lot smaller.

    Comment by nonegiven — December 10, 2007 @ 12:07 pm |Reply

  2. I will pick up that book. But I am disappointed in one thing about low carbing. I have been very low carb for over six months now and have had many wonderful improvements in my health. But the frequency of my migraines is the same. In fact, I had the worst and longest one a few weeks ago! I was so hoping that they would go away! :(

    Comment by Kristine — December 10, 2007 @ 12:30 pm |Reply

  3. Kristine – I’m sorry to hear that, but it’s also useful information to me as I try to decide whether to stop Inderal. Unfortunately, migraine causation is complex, and what works for some people fails miserably for others.

    nonegiven – thanks for the Bernstein link. Whatever it was, CTS or neuropathy, it is always much better when I stick to LC. The thing about this that really yanks my chain is that I think any doctor, when faced with a patient who exhibits multiple risk factors for diabetes AND displays numbness and tingling in the extremities, ought to order a GTT immediately.

    Comment by psipsina — December 10, 2007 @ 2:05 pm |Reply

  4. A couple of comments….the media did such a good job at demonizing Atkins that most people think low carb is the devils diet…

    I don’t know if I’m considered a true low carber, but I have reduced my carb intake…allowing myself no more than 50% or less of my calories to come from carbs, and those mainly complex non-processed carbs as much as is possible…before I was eating a 90% carb diet with very little fat…I’ve increased my fat to 30-35% which was difficult for me, so convinced was I that fat was the enemy…Initially eating more protein, fewer carbs did seem expensive…but I find I don’t eat as much overall because I’m not hungry all the time, and I’m not buying the junk or the expensive processed cereals and such, so it works out to costing about the same and I’m healthier for it….I spend a lot more money on veggies now too, but they are still a bargain compared to the Frankenfoods.

    Finally, I had migranies for about 10 years…at the beginning they were not diagnosed as such because I didn’t see an “aura”…but later it was determined they were migraines…this was back in the early 80’s….I remember the first migraine I had…it lasted 10 days, and it was debilitating…I went to work with Sprite and Pepto for the nausea, and as soon as I got home went to bed and stayed there…couldn’t stand the light…this headache lasted 10 days, no pain killer made a dent in the pain and I didn’t have the sense to go to the doctor at the time…had never heard of a migraine…thought I had the flu or something… Following that, I had, off and on, debilitating headaches, although none as severe as the initail headache, for a period of several years.. I was 31 when they started and in my early 40’s when they ceased and never returned…I think hormones played some role in the headaches…I also did eat a very high carb, highly processed diet too, devoid of important nutrients..that is when I began to self study nutrition, trying to find help for my misery……Said all this to say, perhaps at some point in time your migraines will go away like mine did…

    Comment by Cathy — December 10, 2007 @ 10:17 pm |Reply

  5. I have this book on my Christmas wish list! Dr Mike recommended it a while ago and at 53 I figure I need all the help I can get!

    Comment by Cindy Moore — December 11, 2007 @ 10:41 pm |Reply

  6. Howdy,

    If you haven’t gone there already, Jenny at http://www.phlaunt.com/diabetes/16162241.php (What They Don’t Tell You About Diabetes) has some good info about hyperglycemia-related tendon problems that may be of interest.

    Comment by Anna — December 12, 2007 @ 1:02 am |Reply

  7. Okay, does the universe have to hit me over the head with a 2×4 again and again before I give up the carbs?? *sigh*

    I get it, I get it!

    Comment by Queen B — December 21, 2007 @ 6:02 pm |Reply

  8. You posed the question about the best way to be ketogenic but not lose weight.

    I think the best way to accomplish this is to eat a lot more fat calories in a day. Add as many fat calories as you want to keep from losing weight. At some point you’ll find a level of added calories that will prevent weight loss. And the extra fat will just enhance your ketone levels.

    Just keep a stick of butter with you all day and take a lick or a bite from time to timel;)

    Comment by itsme — February 9, 2008 @ 2:59 am |Reply

  9. I could facilitate out probably all of them in britney spears showing private parts because of that book.

    Comment by gawFlata — February 24, 2008 @ 8:41 am |Reply

  10. It makes a lot of sense. Back when I was a vegetarian (and perforce eating a very high-starch diet) I was getting 1-2 migraines a week. Like others commenting here, I went on a low-carb diet to lose weight, and simultaneously eliminated caffeine from my diet (no chocolate, tea, coffee, or soda) because it wasn’t good without sugar. I lost thirty pounds, which was great. But even better: my migraine incidence is less than one per month now. I don’t know whether it is the low-carbing or the nixing caffeine or the no-wheat that did it. It seems like I’ve quit caffeine several times before and not had that result. Whatever the mechanism, I’m happy with the outcome.

    Comment by Cord — April 22, 2009 @ 8:12 pm |Reply


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