How Changing My Diet Has Dramatically Helped With My Migraines
Guys. I promise this isn’t a clickbait article. I promise this ramble doesn’t end with me eating pizza and a side of Voodoo donuts. I promise this article doesn’t trivialize the adventures and misadventures of elimination diets. Because we all see these titles, roll our eyes and know how they’re going to end. This will have a different ending.
I remember it clearly: soon after being diagnosed with chronic migraines, sitting on the corner of my bed in my shrinking Brooklyn studio, sobbing on the phone to my kindly neurologist, begging him for any level of relief. “Is there anything I can do? Is there anything I should or shouldn’t eat?” And then, in his clipped Eastern European accent, he said, “Maybe avoid nuts?” All I could think about was the Kind bar I had just inhaled. Suffice to say, this was my first baby-step into a migraine elimination diet.
A few weeks later in the vestibular rehab therapy wing of NYU Langone’s mid-town facility, my vestibular therapist gave me my first migraine elimination diet sheet. I was obsessed. Suddenly, as though a light had turned on, I discovered a way to improve my migraine threshold and expedite my path to recovery. Food suddenly was friend and foe.
A migraine elimination diet is a controlled way of eating. You completely eliminate potential food triggers (chocolate, avocado, bananas, onions, yeast, msg, nitrates, soy, citrus, histamines, etc.) for at least four months. If you don’t find a level of relief within those four months, it’s recommended to eliminate other potential triggers like eggs, dairy, gluten, or seeds. If you do feel relief after four months, you can begin testing potential triggers, one week at a time. The process seems overwhelming. But, when you look at the science and reasoning, it makes sense.
At this point I admit I wasn’t thinking clearly: with daily pain levels resting at a solid eight and dizziness at a nine, I scarcely was able to read. Nevertheless, I persisted. I cleared out my kitchen, throwing out food triggers and refined sugars. I downloaded the Migraine Checked app, and Googled whether or not foods were potential triggers. (Seriously? Passionfruit?) Always the perfectionist, I knew I was going to do it to my best ability. No cheats. No remorse over missing a Dough donut or everything bagel with cream cheese, turkey and tomato. So long gummy bears and your pesky gluten and Red Dye #40!
In the beginning, I was too afraid to eat anything but chicken and rice. Food anxieties wrapped their tentacles around me, and I was terrified to try spices, honey or anything beyond the safe banalities of chicken and rice. Even my breakfast cereal was puffed rice. My afternoon snack? Rice cakes. It was monotonous, and I lost a lot of weight in three weeks (admittedly, I had just begun Topamax, which definitely contributed to the dramatic weight loss). It wasn’t a sustainable way of eating. I craved vegetables and fruit. And gummy bears.
Over time I became more and more familiar with migraine elimination diets. My daily pain levels reduced to a six, then a four. Feeling more empowered, I gave up dairy and gluten, feeling it would help not only with migraines but also with sinus and fibromyalgia issues. I felt more confident eating leafy greens like kale and spinach, I found strawberries kind of tasted like gummy bears and I even discovered a few neighborhood spots that served a few meals I could handle (hello, kale salad with butternut squash, pumpkin seeds and olive oil… I see you coconut ice cream in a gluten-free cone!). I gained back a little weight.
Finally, I returned to reading. My first book? Heal Your Headache: the 1-2-3 Program. Always a voracious reader, I gobbled up the information in just two days. Then I gorged myself on a piece of gluten-free toast with sunflower butter and smear of honey. It tasted luxurious.
Cooking soon became my relief. Although still wary of food, I began to feel empowered and inspired by it. I established my safe meals and stuck with them. I shared recipes with my migraine support groups (coconut chicken tacos with a green apple chutney!). Introducing anything new had potential to destroy me for a week, so I stayed within the safe confines of leafy greens, yams, peaches, strawberries, green apples, popcorn, fresh meats, herbs and seeds.
Five months into my migraine elimination diet, I moved across the country (it was July of last year). My neurologist at NYU recommended I stay on the diet and wait several months to get settled before testing triggers. “Any deviation in routine can exacerbate a migraine cycle,” she explained, “so it’s best to stay on your elimination diet until October or November when things have stabilized, then test triggers.” So that’s what I did (and yes, the move definitely impacted my migraine cycle). October came, and I tried Whole30. I ate my weight in sweet potatoes. I dreamed about Snickers bars. I craved sugar. At times I considered pouring bags of sugar straight into my gaping open mouth. This was not the diet for me, so, upon completing it, one of my specialists at UCLA recommended the ketogenic diet.
Ketogenic diets, he explained, were developed for children with epilepsy. They are high-fat and low-carb, putting your body into a carb starvation mode that produces ketones. When your body produces ketones, those nasty free glutamates bouncing around the brain calm down, improving one’s migraine cycle. “Give me a week,” I insisted, “I need a week to test a few triggers and enjoy cereal.” Man I love cereal.
And so I did. I ate a lot of cereal that week, but I also discovered I could tolerate avocado and almonds. Success! Then I dove headfirst into ketogenic education. I joined even more Facebook groups (coincidentally, my migraine diet Facebook group was beginning to tout the keto benefits), I scratched my head at the keto groups’ conflicting information, reworked my macronutrients again and again (How many fats do I need? Is fat a goal or is it a lever? Say what about protein?) and continued to eat as cleanly as possible, while avoiding most migraine triggers. I figured out how to make keto-granola and pretended it was cereal. Within five days my brain fog was entirely gone.
For the first time in two years I could think clearly and process information as quickly as I did pre-chronic migraine. Word recall returned. I gained more weight back.
Ketogenic diets for migraine, I learned, are different from other ketogenic diets. I met with UCLA’s ketogenic nutritionist. Her entire focus is on how patients can improve their quality of life by following a high-fat, low-carb diet. We reviewed my meals (dairy-free yogurt and almonds for breakfast, cobb salad for lunch, protein and vegetables for dinner). I transitioned from being a cereal eater to being a serial eater, repeating safe meals again and again and again. While I was eating colorfully and healthily, she explained that I was eating too much protein and that neurological patients need more fats in their keto diets. She also wanted me to increase my fiber and carb count to 20 net carbs a day. We did so much math. “Every meal needs to follow your specific macronutrient ratio,” she explained. I tested nuts, then discovered that nuts still are not my friend. I then educated her on the finicky nuances of migraine triggers. We still email one another often; it’s all a very fine balance. But, for the most part, I’ve been able to reintroduce many migraine-y foods into my diet, like dairy-free almond-based yogurt, chocolate and nitrate-free deli meat.
So we’re tweaking things. This week we’re testing my blood so we can further refine my macronutrient ratios (i.e. how many carbs, fats and proteins I can have in a day). Since making the fat adjustments, I’ve had just three isolated attacks in April (last April I had a migraine every day, and had a visit to the emergency room). My dizziness has subsided so much I was able to visit Universal Park this past Friday. I rode rollercoasters! I felt attached to my body. I felt present.
Now my abortive meds work more effectively. I can take a Naproxen and trust it will actually work. Migraine Buddy greets me with the friendly “Congrats! You’ve been attack-free five days!” Now that my threshold is stronger, restaurants aren’t as terrifying. I even can enjoy a simple cocktail when the occasion arises. Bonjour, champagne. It’s nice to have you back in my life.
Once too afraid to leave my tiny hamlet by the sea, I’ve taken three-day trips over the past three weekends. I always pack snacks and emergency migraine kits. I still instinctively check menus and make the necessary adjustments (I’ll have the salad, no cheese, no nuts, no apples but extra avocado and eggs please. Oh, and a side of olive oil). I don’t live with the fear and loathing that once kept me confined to just eating chicken and rice. I have the freedom to eat so much more. And this is coming from someone who has given up sugar, gluten, dairy, yeast, msg, most complex carbs, nuts, soy, caffeine, gummy bears, cereal and so much more.
Any chronic migraineur knows that the guarantee of a migraine cure is like searching for meaning in a Pauly Shore movie; however, there are things we can do to empower ourselves and improve our quality of life. I’m now empowered to do more activities because of vestibular rehab therapy and cognitive behavioral therapy. Following a dairy-free ketogenic and migraine elimination diet has greatly improved my tolerance of foods, as well as my migraine threshold. And thanks to skipping dairy, I haven’t had a sinus infection in over a year. I’d say that my quality of life has improved significantly over the past year.
Do I ever crave the naughty no-no foods? Ehhh. Not really. Sometimes I’ll walk by the coffee shop and get a good creep on a hibiscus blood orange donut. I’ll remember its airy texture and how the sugar used to crunch giddily under my teeth. But then I remember the past two years and how much I’ve lost as a result of chronic migraines. Do I want to not be able to walk down a hall again? Do I want to give up my job hunt? Do I want to sustain a daily pain grade of eight? All for a hibiscus blood orange donut??
Nah… It’s just not worth it anymore.
We want to hear your story. Become a Mighty contributor here.
Thinkstock photo via nensuria.