Keto Diet And Migraines

keto diet and migraines

The ketogenic diet, or keto diet, is a diet rich in fat, moderate amounts of protein and very low in carbohydrates. It has long been used to treat epilepsy, a brain disorder that causes seizures. Because of its therapeutic effectiveness in managing epilepsy, the keto diet has been suggested for the relief or prevention of other brain disorders, such as migraines. This article examines the evidence to determine if the keto diet can help prevent migraines.

What is a Keto Diet?

A ketogenic diet – or keto diet – is a diet that heavily reduces carbohydrate consumption and relatively increases the proportion of protein and fat in an individual’s diet.

Studies have shown that the ketogenic diet has mixed results. Ketosis occurs when blood sugar levels begin to drop due to fasting or avoidance of carbohydrates. This causes the brain and central nervous system (CNS) to use ketone bodies (KBs) in the blood as a source of energy because there is not enough glucose. Ketone bodies can also be used as a form of energy by tissues and other organs.

What are Migraines?

Migraine is a common headache disorder characterized by moderate to severe episodes of unilateral throbbing pain in the head. Other symptoms of migraines include increased sensitivity to sound and light, and nausea.

Because there are many different causes, the manifestations of migraine can vary greatly between individuals. Genetic causes of migraine have been widely discussed, and polymorphisms in certain genes have been shown to contribute to the development of migraine.

Migraine also has comorbidities with other psychiatric disorders, which may exacerbate attacks in migraineurs or even contribute to the development of migraine.

Other psychiatric disorders that are comorbid with migraine include anxiety, bipolar disorder, stress, post-traumatic stress disorder, substance use (i.e., tobacco), and eating disorders.  

The Keto Diet and Migraine Prevention

In recent years, there has been an increased interest in KB research in order to treat neurological disorders.

There are three types of KBs. d-beta-hydroxybutyrate (D-BHB), acetoacetate (AcAc) and acetone. D-BHB accounts for approximately 70% of the KBs produced during ketosis. d-BHB is also a glucose transporter protein and an important signaling molecule, making it a potential therapeutic target.

Several case studies (descriptions of individual patient outcomes) have been published on the use of ketosis for migraine control. While there have been reports of reduced migraine attacks, this issue has not been evaluated in well-designed studies to determine the cause and effect.  Scientists continue to investigate the mechanisms by which migraine may be related to KB metabolism. A number of mechanisms have been proposed to explain the relationship between migraine prevention and ketosis, including hypoglycemia, glucose transport, oxidative stress, inflammation, and the gut microbiome.

Hypoglycemia causes migraines because the brain has low energy stores and high energy demands. Neuroimaging has been used to demonstrate this. KBs have been shown to counteract the negative effects of hypoglycemia.

Glucose transporter proteins (GLUTs) are important for transporting glucose to the brain. Their polymorphisms can lead to migraine attacks. However, KBs are transported to the brain via microcarboxylate transporters (MCTs) that are independent of GLUTs. A ketogenic diet may upregulate GLUT1 and MCT expression, thereby increasing energy availability in some GLUT1-deficient/disabled individuals.

Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are necessary for cellular signaling; however, many common migraine triggers may increase ROS and RNS levels, thereby triggering oxidative stress in migraine. KBs – especially D-BHB – have been shown to reduce ROS and RNS levels, which could theoretically help reduce migraine attacks.

Further Researches Are Still Needed

Current evidence suggests that the keto diet can help reduce the frequency, duration, or severity of migraines.

However, there is still much to learn about the keto diet before it can be routinely recommended as a primary or complementary treatment option for migraineurs.

For example, it is not known whether ketosis must be maintained continuously or only part of the time in order to exert its protective effect against migraine.

In addition, all studies showing beneficial effects of keto diets on migraine have been conducted in overweight or obese adults as determined by body mass index (BMI).

Therefore, it is not known whether adults with a body mass index in the “normal” range would have the same benefits.

Most of the studies were also conducted by the same group of researchers in the same geographic location and setting, which may bias the results and limit the generalizability of the findings to other populations.

In addition to the weaknesses of these studies, the keto diet may be difficult to follow over time and lead to changes in bowel habits. In addition, it may be contraindicated in patients with certain liver diseases, such as pancreatitis, liver failure, and fat metabolism-related disorders.

Interestingly, a study is underway to determine if ketone body supplements can prevent migraines.

Exogenous ketone supplements are produced synthetically, but have been shown to increase blood levels of ketone bodies, mimicking what happens when following a keto diet.

In other words, ketone supplements may be an alternative to following a keto diet for managing migraine attacks.

However, more research is needed to confirm the ability of the keto diet to manage migraines.

The Bottom Line

The keto diet is a diet that shifts your metabolism from burning carbohydrates to burning ketones as fuel.

These ketone bodies may have a protective effect on migraines, a brain disorder that causes tingling headaches.

While promising, more research is needed to determine the efficacy of the keto diet for managing migraines.

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