Question - Ketogenic Diet

Hi All,

It’s been a while since I’ve poked my head in. I have a question for Scott or Dr. Lisa, or anyone else who may know of any studies that may have been done on the effectiveness of a ketogenic diet for migraine relief. I’m only finding tidbits of information on the internet relating to the diet and migraine.

I’ve mentioned before that eating low-carb is key to my symptom control. I’ve recently discovered that eating very low-carb (5-7% of calories), moderate protein (20-25% of calories), and high fat (65-75% of calories) makes me feel almost normal. All that is left most of the time if I’m strict with the diet is visual snow and mild tinnitus. I have an appointment with my doctor next month. I plan to talk to her about this if it continues to work for me because I realize I need to supplement some vitamins and minerals and I need to be monitored by a doctor and/or nutritionist. I’m hoping there is some medical literature out there supporting what I have found on my own. I know the ketogenic diet is effective for seizure control for some.

Scott, Lisa, or anyone elso have any information they can share with me?


Marci :smiley:

Hi Marci,
I am not aware of any connection between migraine control and the ketogenic diet and was unable to find any literature supporting this. However, a lower carbohydrate, moderate protein, and moderate fat diet would stabilize blood sugar. I suppose it is possible you may be super sensitive to the spikes and dips of eating carbs so a ketogenic diet may keep a steady supply of glucose to your brain. If it works for you, don’t question it, make sure you are monitored for acidosis and feel good!
Sorry I couldn’t be of more help.

Hi Marci,

I too am unaware of any solid link between a low-carb diet and migraine control although as Lisa said, it might be keeping your blood glucose levels more stable or your insulin levels from spiking which is somehow keeping your brain from going off on a migraine tangent.

Marci, are you sure it’s “low carb” per se that is responsible, or is it low glucose spikes and thus more well-controlled plasma insulin levels? You can achieve the same result by choosing low glycemic index carbs too without having to starve yourself of carbohydrate. This would mean having a diet that is much more sustainable and you wouldn’t potentially be missing out on other micronutrients. We never promote low carb diets because of the difficulty in sustaining them and because of the possible increased risk in CVD from the higher fat intake (primarily via saturated fat). There’s also other issues such as constipation and the need for multivitamins.

I’m interested in knowing what sort of carbs result in headaches and symptoms again when you reintroduce them. It’s fascinating that you have better control by avoiding them. Have you tried reintroducing certain carbs again since being on Zoloft?

Cheers … Scott

Lisa and Scott,

Thank you very much for your replies.

I’m 100% sure I must follow a low-carb diet to get the best results. I’ve been playing around with this for a year and a half. I’ve tried eating low-glycemic index carbs, and while I do better on them than eating a diet with sugar and other high GI carbs, I definitely don’t have the same great results that I do eating very low-carb. I think the stabilization of my blood sugar is a big component of why it works, but I think there is more too it than that. For one, I believe the diuretic effect of the diet makes my head better, because it only takes a couple days of low-carb and a few pounds of water loss to start feeling better. There may also be a gluten intolerance component based on my digestive symptoms after eating gluten-containing foods. I don’t have any test results to confirm intolerance though.

But my instincts tell me there something more to it. If the diet works sometimes for seizure patients and anti-seizure meds sometimes work for migraines, it is not a huge stretch for me to think perhaps the diet could sometimes work for migraines especially since I have tested it myself with the same results numerous times - mainly because I felt better, became lax with the diet, felt worse and eventually went back to the diet with the same positive results time and again. (You would think this would motivate me to have a little more willpower and stick with it. :roll:) I know others have had similar results.

I have reintroduced various carbs a few times since being on Zoloft and Zonegran. The results are varied depending on my other triggers of course, so it’s not easy to point to the cause sometimes. I love grains, but they make me lethargic and gassy. I think fruits are generally okay from a migraine perspective for me, but they raise my insulin levels and cause me to crave more carbs. Non-starchy vegetables are fine.

I just know that I can keep my head above water if I stay very low carb. It is still important that I get my sleep and avoid my triggers. The diet is not a cure-all, but it does seem to be one thing that consistently makes me better if I follow it. The Zoloft and Zonegran have each helped too, but I seem to need the diet to stay consistently well. Believe me when I tell you I would be the last person to want to eat low-carb if it didn’t make such a difference in how I feel. I am a carbaholic! Maybe that is why I am in this situation in the first place – I’ve bombarded my body with the junk carbs for 30+ years!

Sorry for rambling. If I figure this out, I’ll be sure to share with you all.

Marci :smiley:

Hi Marci,

I’m sure you’ve looked at all angles of this and tried to work out what exactly is working. You’re a good skeptic. Might be worth testing the gluten thing too in case that’s the culprit. What happens if you eat legumes? So for example, if you ate a sald with tomato, cucumber, avocado, bean sprouts and a can of 3 bean mix would that set you off? The beans are not a great low GI test food however, because they can trigger migraine all by themselves without any carb component having a possible effect.

I’m glad you can eat all of the non-starchy veggies. What happens if you eat a small portion of sweet potato? Or what about squash? Does a small serve of pasta cooked al dente leave you feeling off or is it all something that builds over a few days of eating more carbohydrate. The problem with the diet and migraine is that it can be really hard to know precisely what is causing the increase in migraine activity: is it the carb? the food itself? gluten? a glucose problem or an insulin effect? or is it all a diuretic effect?

I guess if you can sustain the low carb approach and aren’t suffering for it with side effects then you may as well stick with it. Interestingly I came across a study that showed the opposite effect in those who did not keep glucose levels filled up with a normal carb load throughout the day. The author stated that the increase in gluconeogenesis from the lack of carb in the diet was triggering migraines in migraineurs. Clearly, you are experiencing quite the opposite. Go figure. Just typical with this lousy junk illness … waht works for one person can be a disaster for the next one as we see with meds.

Scott :?

I recently tried the Atkins Induction phase and only lasted 4 days on it! Not because I was craving carbs on the contrary I was so nauseous I didn’t want to eat anything. The big thing is that I became SOOO extremely dizzy I could hardly get around. I was tired and out of it and a little depressed, oh and awful diarrhea (sorry TMI) . Maybe this was a withdrawal of some kind or maybe my brain was not getting enough serotonin but I wish the diet didn’t effect me so much so maybe it could help control some of the dizziness. Some on the internet say the MORE your body reacts to low carb low sugar the more you can benefit from it after it adjust. I just didn’t think the dizziness would ever stop though. I ate some cereal and a banana for breakfast and the extreme dizziness is gone. I don’t get it??? Can anyone relate??