My carbohydrate days are over. Goodbye, sugar! Goodbye, potatoes! Goodbye, bread! Goodbye, cookies, cakes, and other goodies!
I've been on a ketogenic diet since December 27 and I didn't need any migraine medication between January 1 and January 30. That's the longest I've gone without migraine meds in 10 years!!! February and March haven't been quite as spectacular, but they've still been much better than my previous 2-3 migraines per week with significant chronic daily headache.
So, what's the ketogenic diet and why and I doing it? Let me answer the second question first. The ketogenic diet has been used since the 1920s and 30s to treat severe seizure disorders before medications were available. After the development of medications, the diet treatment fell out of favor and is now only used for intractable cases that don't respond to any medications. (And, it's become even less commonly used for seizures now that cannabis is more available.) Since anti-seizure medications are often effective more migraines, it makes sense that they would help with migraines. And, indeed, there are anecdotal reports of a ketogenic diet helping people with chronic migraine.
Now, what is a ketogenic diet? Basically, it is a low carbohydrate, high fat, moderate protein diet. The body normally runs on glucose (the most basic carbohydrate) for energy. In a ketogenic diet, we force the body to use fat and ketones for energy. The brain is a major user of energy and it usually uses all glucose, but when there are limited amounts of carbs around, it will run on a small amount of glucose and mostly ketones (which are made from fat - fat doesn't cross the blood-brain barrier).
I get to eat lots of meat, cheese, vegetables (above the ground, not starchy). During the first 2 or 3 weeks, I didn't feel really well; I had "keto flu". It takes time for your body to adjust to using a different fuel source. Now that I'm used to eating differently and getting plenty of water every day, I feel really well. My daily headaches are still present, but at a 1-3/10 level. I've had several migraines, but I can identify the triggers and they responded pretty well to medications.
The keto diet is becoming popular as a healthy way to eat and lost weight. So far, I've lost 25 pounds and, because the headaches are less, I'm able to exercise more. Here's the website that I've found most helpful. One of the difficult things about the ketogenic diet is that you have to get into ketosis, where you are burning fat and ketones, and stay there. If you go back to eating more than your allotted number of carbs per day (20g for me), you will drop out of ketosis and start using carbs for fuel again. The problem with that is that it takes several days or so to get back into ketosis. So, you can't just cheat tonight and get back on plan in the morning. Cheating is a big deal.
I'm not completely sure how this is helping my migraines. Somehow, the change from using all glucose to using mostly ketones for energy has changed the chemistry in my brain. The reading that I've done suggests that there is less glutamate (which is excitatory) around and more GABA (which is inhibitory) around.
In any case, I really miss my sweets, but I really like the lack of pain more!! So, hello, meat! Hello, cheese! Hello, eggs!! Hello, spinach!!