Definition of Migraine

Migraine is a genetic condition. Migraine brain has hypersensitive sensory neurons, more sensory neuronal connections, and different electrical properties than a typical brain^1,2. Migraineurs waste 50% more sodium in their urine than typical subjects³. The most prominent migraine related genetic variants are associated with critical ionic channels that operate the brain’s electrical functions: action potential, resting potential, the delivery of neurotransmitters, and the resetting of the membrane potential^4,5. Migraineurs’ brains are very sensitive to electrolyte imbalance as a result of channelopathy^6-9. Migraineurs tend to end up with metabolic syndrome because of their carbohydrate sensitivity.

Diagnosis

 Migraine is often misdiagnosed. A short summary to help diagnosis—for a deeper understanding of the diagnostics, please read the book “Fighting The Migraine Epidemic: Complete Guide: How to Treat & Prevent Migraines Without Medicines”:

• Migraine is not a headache and need not even come with a headache.
• Migraine is unilateral—the brain’s architecture is of two separate hemispheres.
• Migraine doesn’t throb—migraine is not a vascular condition.
• The difference between migraine types is the location of the electrolyte imbalance.
• Migraines are always preceded by prodromes. Some prodrome types may start 1-2 days prior to a migraine, others may precede it by only an hour or less.

Causes of Migraines

Migraines are directly caused by an electrolyte imbalance. The brain primarily uses GLUT3 to transport glucose into the neurons and GLUT1 to cross the blood brain barrier. These GLUT transporters are voltage-gated-sodium-dependent transporters¹⁰ (SGLTx) of glucose. As a result, and because of the more active sensory neurons of the migraine brain, there is more fuel needed. Since glucose entering cells removes sodium and water from the cells¹¹, this causes electrolyte imbalance and edema. Hence migraines are caused directly by the consumption of carbohydrates, not enough sodium, and water collected in edema. Contributors to electrolyte imbalance include:

• Carbohydrate consumption.
  • Therapeutic Carbohydrate Restriction – Limit daily carbohydrates to <x grams.(*1) 
  • No need for ketosis, Medical Ketogenic Dietary Therapies (KDT), or carnivore diets.
• Dehydration and improper hydration:
  • drinking liquids other than water,
  • drinking water without salt.
• Supplements that may not be necessary: multivitamins, potassium, zinc, selenium, etc.
• Medications prescribed for migraine that are also used for other conditions, such as beta blockers, anticonvulsants, SSRIs, SNRIs, SARIs, and others.
• High potassium/sodium foods without balancing sodium & potassium in equal amounts. In the human body, sodium and potassium are approximately in the same amounts, so consuming food in which sodium is in greater or lesser amounts than potassium will cause an electrolyte imbalance.
• Emotional events: both overly happy and overly sad.
• Barometric pressure changes.
• Menstrual cycles and/or ovulation

To Treat an Ongoing Migraine:

Understand what directly caused the migraine. For example, if carbs with a lot of potassium, take salt (*2) without water to match potassium 1:1. If carbs without any potassium (aka sugar or junk food) take salt without water (300 mg sodium, 1/8th teaspoon salt). If pressure drops, take salt with water. If pressure increases, eat high-potassium foods like avocado or salmon. There are many tips & tricks so seek help from Stanton’s migraine group on Facebook.

Prevention

Migraines are preventable by eating a low carbohydrate and high sodium diet—no need for ketone supplementation or the ketogenic diet. High sodium is more important than being in ketosis. Potassium should never be supplemented, but sodium should be supplemented all day long. For how-to details please contact Angela Stanton by the contact form.

Footnotes:

^*1 Hite, A. (2020, September 25). Clinical Guideline for Therapeutic Carbohydrate Restriction. Society of Metabolic Health Practitioners. Retrieved October 6, 2021, from https://thesmhp.org/clinical-guidelines/.

^*2 While there is a common belief that salt increases blood pressure, studies show this to be incorrect. It is sugar that increases blood pressure  12   Sharma, N. et al. High-sugar diets increase cardiac dysfunction and mortality in hypertension compared to low-carbohydrate or high-starch diets. Journal of hypertension 26, 1402-1410, doi:10.1097/HJH.0b013e3283007dda (2008); 13 DiNicolantonio, J. J. & Lucan, S. C. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 1, doi:10.1136/openhrt-2014-000167 (2014); 14  Nichols, H.     (2015); 15  He, F. & MacGregor, G. Salt and sugar: their effects on blood pressure. Pflügers Archiv – European Journal of Physiology 467, 577-586, doi:10.1007/s00424-014-1677-x (2015)..

Sources:

1          Ambrosini, A. & Schoenen, J. The electrophysiology of migraine. Current Opinion in Neurology 16, 5, doi:10.1097/01.wco.0000073945.19076.1f (2003).

2          Tso, A. R., Trujillo, A., Guo, C. C., Goadsby, P. J. & Seeley, W. W. The anterior insula shows heightened interictal intrinsic connectivity in migraine without aura. Neurology, 1043-1050 (2015).

3          Campbell, D. A., Tonks, E. M. & Hay, K. M. An Investigation of the Salt and Water Balance in Migraine. British Medical Journal, 1424-1429 (1951).

4          Science, W. I. o. The Human Gene Database, <http://www.genecards.org> (2017).

5          Liu, H. et al. Resting state brain activity in patients with migraine: a magnetoencephalography study. The Journal of Headache and Pain 16, 42, doi:10.1186/s10194-015-0525-5 (2015).

6          Lee, J.-Y. & Kim, M. Current Issues in Migraine Genetics. J Clin Neurol 1, 8-13 (2005).

7          Albury, C. L., Stuart, S., Haupt, L. M. & Griffiths, L. R. Ion channelopathies and migraine pathogenesis. Molecular Genetics and Genomics 292, 729-739, doi:10.1007/s00438-017-1317-1 (2017).

8          Stanton, A. A. Migraines and Ionic Variances. The FASEB Journal 32, 750.751-750.751, doi:https://doi.org/10.1096/fasebj.2018.32.1_supplement.750.1 (2018).

9          Stanton, A. A. Channelopathy and Carbohydrates: Bad Mix for Migraines. The FASEB Journal 34, 1-1, doi:https://doi.org/10.1096/fasebj.2020.34.s1.02286 (2020).

10        Mora, S. & Pessin, J. in Encyclopedia of Biological Chemistry (Second Edition)   (eds William J. Lennarz & M. Daniel Lane)  391-394 (Academic Press, 2013).

11        Longo, D. L. et al. Harrison’s Manual of Medicine 18th Edition.  (McGraw Hill Medical, 2013).

12        Sharma, N. et al. High-sugar diets increase cardiac dysfunction and mortality in hypertension compared to low-carbohydrate or high-starch diets. Journal of hypertension 26, 1402-1410, doi:10.1097/HJH.0b013e3283007dda (2008).

13        DiNicolantonio, J. J. & Lucan, S. C. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 1, doi:10.1136/openhrt-2014-000167 (2014).

14        Nichols, H.     (2015).

15        He, F. & MacGregor, G. Salt and sugar: their effects on blood pressure. Pflügers Archiv – European Journal of Physiology 467, 577-586, doi:10.1007/s00424-014-1677-x (2015).