The low carb, high fat way of life is the only natural intervention I have found to make any difference in lowering the frequency of my migraine attacks, given that I was already leading quite the regimented life, even before making the switch. I have found my way to this way of life after my neurologist said that restricting the carbs in one’s diet helps some people better manage their migraine disease. When I heard this, I thought: I already don’t eat sweets, so what exactly is he talking about?
So, I went home and googled “migraine carbs restriction”. I found some information about how switching to an “ancestral diet” might help. This sounded to me too much like Paleo, for which there is no scientific backing. But, thankfully, on the same site, there was a mention of how a “ketogenic” diet might help. This was my “Eurecka!” moment. I searched for it and found that a ketogenic diet was successfully used for the management of seizures in epilepsy sufferers. It was also found, by accident, to help reduce the frequency of migraine attacks. No wonder, since epilepsy and migraine are very close cousins! It was by accident that Botox was discovered to help, too: people who wanted to get rid of wrinkles found that they got fewer migraines when getting their injections! In much the same way, people who started doing keto for weight loss reported that they got fewer migraines.
Very briefly, a ketogenic diet is supposed to induce nutritional ketosis, in which the organism starts using ketones as the primary source of fuel. Ketones are produced by the liver, when it encounters enough fat in the system. Since glucose is not readily available when one eats this way, the body must function on ketones. The brain, of course, needs some glucose to function well. It gets this by a process called “gluconeogenesis”. To do so, the organism must have enough proteins to use to transform into glucose.
So, to ensure things work this way, one must have roughly this proportional distribution: eat 70% fat, 20% protein, and 10% carbs. Things work roughly this way, because getting into ketosis is personal: I can do it on 40 g of carbs/day (closer to 20% of all the macros); others need to ingest no more than 20g of carbs/day. To keep hunger at bay, one supplements with clean fat.
Nor is it entirely necessary to go full ketogenic to prevent migraine attacks. Moreover, some of the things one can eat to stay in ketosis don’t help with migraine attack prevention. I discovered this to be true for me: I need to refrain from eating dairy and nuts for now, for independent reasons. As explained here, nuts and dairy can trigger migraine attacks, anyway, so one needs to be mindful of using them sparingly. So, what one needs to find is what kind of low carb, high fat diet works to prevent their attacks.
I read as much as I could on this. I was concerned all this fat might be detrimental to the health of my heart, for instance. It took me a year to have enough courage to make the transition to this way of life. ONE WHOLE YEAR! Whereas, it took me about 15 min to choose to have Botox injections, despite the many documented side effects.
I’m writing this to urge any fellow migraine sufferers to give it a try. Don’t sit on the information for a year, without taking action! With mounting evidence that ketones help stabilize the brain in all kinds of neurological disorders, this is the cheapest, safest way of intervening. It might change your life. The only thing I recommend, if you do take this path, is to give it a serious try: learn all you can about it and try it for 3 months. This is how long one is supposed to try a migraine preventative medication for. If you’re ready to give Topamax a try for 3 months, do the same with a ketogenic diet! Think about this as medication: it’s not your fault for getting an attack. The most you can do is to try to find the right dose.
To get me started, the main resources I used were these two:
https://ketodietapp.com/Blog
https://www.mymigrainemiracle.com/the-diet/
This website gives you answers to FAQ regarding ketones and migraines. And they link to studies, supporting the claims made (e.g. all this saturated fat won’t make you fat, it won’t clog your arteries, etc.)
I did count carbs in the beginning. Now, after two years of eating mostly low carb high fat, I count nothing! I learned what works and what doesn’t. I will say this: this dietary intervention brought me back from the throes of chronic pain, allowed me to become a mom, and is supporting me in being the parent I want to be. Do I still get migraine attacks? Sure! They are part and parcel of who I am. But, they occur only about twice or three times per month, they rarely last longer than 24 h (usually less than 10 h), and the intensity is hugely reduced. I haven’t had a full blown attack in more than a year (I did get the migraine attack of a lifetime after the epidural I got when delivering Luca. I really wanted to have an unmedicated birth primarily for this reason, but this intervention ended up being necessary). As I said before, I take no meds (no preventives, like Topamax, beta blockers, SSRI or the new CGRP meds; no acute meds, like triptans or ergots) to manage my disease and I feel better than ever! Here’s to hoping that this might help you, no matter where you are on your migraine journey!