Has anyone here gone ketogenic to defeat migraines?

by 1435 · April 24, 2014 at 12:36 AM

I started Paleo seven months ago in part to reduce or eliminate my frequent headaches. Unfortunately, what I'm doing so far has not had the results I was looking for. So eliminating grains and presumably reducing inflammation has not been enough.

I'm thinking about going to a full-bore ketogenic diet, like what Johns Hopkins developed for combating epilepsy. It supposedly has helped some migraneurs. I read on the evolutionary psychiatry blog that the biochemistry of ketosis in the brain is remarkably like the effect of the medication I happen to be on.

In order to start, I'm going to have to wean off the medication (topiramate), because it's incompatible with the blood acidosis that results from being in ketosis. So I'm at least 2-3 weeks away from starting.

In the mean time, have any of you tried the ketogenic or modified atkins protocols for migraines, and what were your results? I'm also thinking about starting out with a relatively long fast (possibly 7 days).


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4544 · January 14, 2011 at 1:03 AM

Hi Domer88,

I'm delighted to hear that you're thinking of doing this because I am currently on day 68 of exactly the same experiment, and I've been wishing there was somebody I could compare notes with!

At the beginning of November, in hopes of curing the migraines from which I had suffered for 47 years, I started fasting and stopped taking sumatriptan. After the fast ended I segued into a Hopkins-style ketogenic diet.

In recent years I was having migraines nearly every day. I had previously tried Atkins induction diets with and without MCT oil. I had been on a very low-carb diet for over three years. I stopped eating grains and legumes years ago. I had tried elimination diets. None of this had worked.

As I'm sure you know, a long fast induces a higher level of ketosis than any diet. That's why I decided to try fasting.

You probably also know that there is a report in the medical literature of a woman who was cured of migraine by a ketogenic diet. She was on an extreme hypocaloric diet (about 700 calories per day) for seven months. I couldn't try that because I wasn't fat enough.

Originally I planned to fast for about seven days, like you, but fasting turned out to be easier than I expected so I continued for thirty days. As the fast went on my migraines became less frequent, less painful, and briefer. The last painful one occurred on the 23rd day of the fast.

The results of the fast and diet have been wonderful. For the first time in 47 years I can say that I haven't had a painful headache in over a month. There are still some migrainey sensations but the migraine process seems to get blocked before it turns into a painful headache. These symptoms are diminishing as the days go on.

Before the fast, I was completely dependent on sumatriptan. Since day 23 of the fast, I haven't even thought about taking it. I don't need it anymore.

I'm not going to describe my fast here because it's described in detail on Paul Jaminet's Perfect Health Blog. Here's the link:


Since the fast ended I've been eating a paleo version of the Hopkins diet -- mainly tallow, meat, and eggs. Plus MCT oil which I guess isn't so paleo! :)

Please feel free to ask any specific questions you have. If you decide to go ahead with this, I would love to talk to you about it.


If I had known last November what I know now, I would have tried one more thing before resorting to a long fast. I would have bought an Abbott Precision Xtra blood meter so I could monitor my blood ketone levels and embarked upon a hard-core Hopkins diet with protein restriction and overall caloric restriction and MCT oil.

I have one of those meters now. (In fact I have three.) I believe the meter allows you to achieve a higher level of ketosis because you can adjust the diet by trial and error and measure the results.

The mistake I made in previous years, when I tried Atkins-induction diets, is that I didn't understand that protein restriction and overall caloric restriction are important factors for attaining deep ketosis.

1658 · January 13, 2011 at 11:57 PM

I used to have migraines, took Imitrex for it. When I finally read the complete package insert, I vowed never to take it again. What helped me -

  • going organic on the foods where it really matters (EWG's pesticide list is a great resource: http://www.foodnews.org/)
  • sleeping in a completely DARK room. That means blocking all light from the outside, keeping cell phone and computer in another room, turning alarm clock around so there is no glow
  • taking in sufficient water each day
  • monitoring electrolyte balance
  • exercising at least 4x/week, some just walking for errands (1mi to grocery store, for example), with weight training on other days
  • making sure known triggers were eliminated/reduced (red wine, poor quality chocolate, cheese or poor quality cheese)
  • I am not completely "paleo" in the strictest of terms, but I only get a strong headache (not migraine) when my blood sugar drops too fast, get too dehydrated after exercise, I wait too long to eat when I'm really hungry, or my hormones are out of whack. I'm a girl, so this last one may not apply to you! ;-)

2297 · January 14, 2011 at 3:45 AM

I tapered off Topamax a lot more slowly, FWIW. I tried that med because I had a headache every day and mild to moderate migraines lasting 3 days, several times a month.

You might consider checking your Omega 3/6 balance. Presumably, you have that in line with the diet; but it is my understanding that it can take awhile (up to 2 years?) to see the full effects of your inflammation reduction efforts.

I tried the Bernstein diet, which is quite low carb at 30g/day. I also experimented with zero carb. My migraines improved substantially, but the real key for me was to be strictly gluten free, as opposed to "not eating grains." I replaced my cutting board and I do not eat bacon wrapped scallops that are cooked on the same grill as crusted fish for example. I do not remove the bun from the burger, etc, etc. GF supplements too, although I am gradually eliminating as many of those as I can.

I would encourage you to consider trace amounts of gluten as a confounding variable. Also, are you eating any dairy? I only use ghee which is casein free; that seems to make a difference for me, but I haven't tested it enough to be certain.

90 · January 13, 2011 at 10:39 PM

I haven't tried that, but I'd be interested to hear your results. And an interesting side note - I ate some wheat two days in a row (and had alcohol), and the next night I had a horrible migraine. I don't think that is a coincidence.

10 · February 12, 2012 at 7:58 PM

Hi. I will be 54 next month. i HAD MY first migraine at 18, but they didn't really get going until I was 32. They have been just awful for the past three year. I have always exercised a lot, but went on 20 mg in Inderal this fall. I have noticed before that , that I was putting on weight. I decided to change my eating to low carb over a month ago. I have gone from having up to 13 migraines per month to NOT ONE, in over a month. I am going to decrease my Inderal to once per day, and keep going. If this is it, it has totally changed my life. I hope this happens to other migrainers. Laurie

20 · October 29, 2011 at 2:17 PM

I got rid of my migraine (which was daily in the end of july this summer), when I discovered that I strongly react on histamine. I threw out all histamine food and the migraine vanished THE VERY NEXT DAY and NEVER CAME back.

After having found out, that I'm sensitive to food in such a high degree, I totally switched to Paleo in the following weeks. Every day a little bit more Paleo. Because I was diagnosed with multiple sclerosis 4 years ago, I'm on the autoimmune protocol and I'm a newborn person now. Big smile :-)))

20 · January 16, 2011 at 10:29 PM

I suffered from migraines for 25 years. Turns out it was aspartame. I drank diet soft drinks on occasion. Never used the little blue sweetener packets, but in going through my pantry and fridge, I found several items that contained aspartame: sugar-free Jello, pickled ginger, and low-sugar pancake syrup as well as others. Now I read every label, and since I purged my diet of aspartame over a year ago, I have been totally headache-free. A miracle, and every day I'm thankful. I've been paleo for just about a year now, too, and never felt better. Here's hoping you find the relief you deserve.


3428 · January 14, 2011 at 4:37 PM

Hypertension is one of the possible causes of migraines. Even mild hypertensions, at levels of blood pressure that people considered safe in the past, could be the reason. If I were you, I would try cutting out all sodium, including the one in bacon or mayonnaise and find out whether your migraines improve with a lower blood pressure.

1246 · January 14, 2011 at 4:09 PM

Do you supplement with magnesium? My migraines disappeared with the wheat, but I still got milder headaches (and other aches and pains) until I went on magnesium regularly. Something to think about before you go full-blown keto.

1321 · January 13, 2011 at 10:28 PM

I went primal/paleo in Nov 2009, I had one migraine since then. Before I would get them pretty much monthly, the kind where you crawl under the mattress and grind your head into oblivion if light enters the room.

I cannot say it was the reason I went primal/paleo/whatever but it has been a very nice side effect.

0 · April 24, 2014 at 12:36 AM

Yes! I still don't think I was having what could really be called a migraine, even though that was my diagnosis. I was having vicious headaches but they would come sometimes before, sometimes after, or sometimes not at all alongside a host of extreme neurological symptoms. They went away since going on a ketogenic diet. I highly recommend mild to moderate ketosis for anyone with brain/neuro/psych symptoms. There's evidence in favor for brain tumors, schizophrenia as well.

0 · April 23, 2014 at 4:27 PM

I have had horrible migraines for 40 years and nothing helped except migraine meds. I have been Ketogenic for 2 months and it has been an absolute miracle. The migraines are gone. I am thankful everyday. Rob

0 · March 20, 2014 at 5:21 PM

I go keto, or at least on a high fat, moderate protein, and very low-carb, diet (try to stay between 20-50g carbs). I feel a million times better, I lose my migraines (or, if the weather induced ones come, they are visual and sensory, but low pain).

The question is why I go back to eating carbs ever! I know this works, I know it improves my acne, my depression, etc., but I slip up every 6 months or so!

My only issue(which makes it difficult to do keto without massive work) Is the fact that I need to keep the dairy low, or other issues flare up.

0 · February 24, 2013 at 1:03 AM

Domer88, I've just discovered on my own that the induction phase of ATKINS prevents the migraines I've had since my teens (I'm 56).

It's been three months now without migraines, where I'd been having 3 or so per week previously.

All the other stuff had failed as preventative treatment - Mild antidepressants and other related meds often worked for two months or so - and the emergency migraine treatments, even the injectables, worked only for the first 3 times or so, and then became totally ineffective.

The remaining treatment is excedrin or anacin; These are unacceptable, though, because I'd get really high on the caffeine, and start an addictive caffeine withdrawal cycle; Last November I wsas up to 5 excedrine a day, not sleeping at all....

I tried the Ketogenic diet as a last resort - After noticing that carb consumption before bed worsened the subsequent '2:00 AM icepick between the eyes'.

It seems to work, but only if I'm really strict. Tests indicate I've always had a tendency toward reactive hypoglycemia.

It's apparently highly variable - Lots of folks seem to talk about the Induction Phase causing headaches. For my body (and yours), it's the opposite.

188 · February 22, 2013 at 9:45 PM

Gluten free cured migraines for me.

0 · February 22, 2013 at 6:29 PM

Any updates? I am trying the diet now and could really use some support!

25 · September 22, 2012 at 1:48 AM


I'm at about Day 50 of living Paleo. I still get migraines due to hormones, certain foods, and certain environmental factors. Going Paleo has not changed my migraine status.


A lot of people have reported success by adding relatively high doses of magnesium to their diets. Mag-Tab SR comes highly recommended on a lot of websites/blogs. I've tried magnesium citrate and it upsets my stomach no matter how small of a dose I take. I've just ordered Mag-Tab SR and hope it makes a difference. If it doesn't, I'm prepared to go keto.

It has been about a year and a half since you posted. Could I have an update?


1185 · August 13, 2012 at 6:53 PM

I have hormones related migraines, so my testimony won't help you much. Frankly my hormones got worse at first with paleo and the migraines did as well. But with a vlc diet and progesterone, I haven't had a migraine at all. Also it helped to keep my salt intake up.

0 · August 13, 2012 at 6:18 PM

I haven't but someone on our migraine forum has been on MCT oil for probably 6-8 months for migraines, and it's working. Here's the blog: http://cure-migraines.blogspot.com/

She was on a ketogenics, which was working, and switched to MCT oil, according to her blog.

37013 · January 19, 2012 at 3:15 AM

I haven't gone fully ketogenic, but I thrive on IF.

Paul Jaminets' new post he mentions that migraine may benefit from a ketogenic diet as migraine can indicate difficulty using glucose in the brain.

I've commented many times of PH that I don't seem to thrive on starches and this may be related.

1452 · August 31, 2011 at 4:34 PM

I tried the ketogenig paleo approach in order to heal my migraines which are highly associated with an energy crisis in the brain due to hypoglycemia/glucose intolerance with similarities to epilepsy.

Critchley M. Migraine Lancet 1933;1:123-6
Wilkinson CF Jr. Recurrent migrainoid headaches associated with spontaneous hypoglycemia. Am J Med Sci 1949;218:209–12.
Roberts HJ Migraine and Related Vascular Headaches Due to Diabetogenic Hyperinsulinism Headache 1967, July,41-62
Dexter JD, Roberts J, Byer JA. The five hour glucose tolerance test and effect of low sucrose diet in migraine. Headache 1978;18:91–4.

Roberts (1967) suggested to change the name of migraine into "hypoglycemic headaches":

"The fundamental metabolic disturbance that usually triggers such headaches is recurrent hypoglycemia … [it is suggested that] the term migraine be replaced by … 'hypoglycemic headache.'"

So it is likely a ketogenic diet can heal the energy crisis in the brain:

Strahlman, R. Scott: Can Ketosis Help Migraine Sufferers? A Case Report. Headache: The Journal of Head and Face Pain. Volume 46 Page 182 - January 2006. doi:10.1111/j.1526-4610.2006.00321_5.x

I improved my migraines vastly during the last weeks while I stayed low-carb and went into ketosis sometimes.

During the first week of transitioning I had constantly mild headaches. Since then (a few months ago) I never had severe migraine again.

For me the cause was hypoclycemia and thus constant blood sugar crashes, hunger and carb cravings. Now my energy levels are much more stable and I can go on without eating for a long time.

I have to add that sleep deprivation gives me migraines, too. So always when I get only a few hours of sleep, the following days are horrible. But I noted yesterday, after an uncommon night of less sleep, I got only slight headaches and no migraine.

I always sleep in a dark room, which leads to good quality sleep.

3221 · August 31, 2011 at 4:22 PM

It definitely kicked my migraines and therefore Topamax to the curb.

0 · February 16, 2011 at 3:21 AM

I'm day two paleo and am doing it to decrease my migraines. I'll post again if I see a big change.

523 · February 15, 2011 at 4:18 PM

I have found a ketogenic Paleo diet to help my migraines. By staying in mild ketosis, my body has adapted to going longer periods of time without food. Since I used to get migraines from prolonged hunger, this has been a huge help. I took Topamax several years ago and experienced little improvement in my daily migraines. I stopped taking it after experiencing vision problems and cloudy thinking.

I have been gluten free for 2 years and Paleo about a year. I am careful to avoid all artificial sweeteners and MSG. You might want to consider supplementing with Butterbur with Feverfew (NOW brand), 2x a day. It has helped me to lower my migraine threshold, less frequent now with less intensity. If you have sensitivity to light (sunlight or flourescent) even without a migraine, you might want to have your adrenals checked.

106 · February 15, 2011 at 5:37 AM

I eat lacto-paleo and less than 20g carbs each day. I'm also trying 16/8 fasting.

I used to get crippling migraines at least once a week.

It's been six weeks since I started this new lifestyle. I haven't had a migraine in about three weeks.

crosses fingers

1377 · February 14, 2011 at 2:01 PM

Good luck to you. Hope your taper goes well. Topomax made me paranoid. I'll be interested to learn how your ketogenic diet goes. I started low carb about four years ago looking for migraine relief. It did help significantly, reducing severity to about half. I've stayed with it, because other unexpected health benefits were amazing. I now eat Paleo, but taking out the remaining grains and vegetable oils did not help headaches. Recently read the Perfect Health Diet, and am trying to move my diet to a more ketogenic style as recommended in that book. Also trying his supplement recommendations, which are not the usual ones. I've done some 36 hour fasts, which seem to help, and would like to fast longer, but I'm worried about losing too much weight. Looking forward to your updates.

315 · January 24, 2011 at 3:21 AM

How are you? Any improvement?

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