Carbohydrates and Migraines (Migraine Miracle Moment)

In this episode of The Miracle Moment, I discuss the crucial connection between carbohydrates and migraines.

EPISODE TRANSCRIPT

[00:00:17] Hey folks welcome to the Migraine Miracle Moment. I’m your host Dr. Josh Turknett. [5.1]

[00:00:22] I’m a neurologist, a migraine specialist, and author of the book the Migraine Miracle, and I’m a migraine sufferer myself. [7.6]

[00:00:30] And the mission of this show, the Migraine Miracle Moment is to help you find your path to migraine freedom, without pills. [7.5]

[00:00:38] And in this episode I’m going to be reviewing the impact of carbohydrates on migraines. [6.6]

[00:00:46] So we’ve touched on this subject somewhat in prior episodes, but it’s a fairly complex topic, and one that’s of particular importance to migraineurs specifically. [12.3]

[00:00:58] What’s often overlooked is the fact that carbohydrates have both short and long term effects on our physiology, so they kind of impact us all on multiple time scales and how it does so is of important for us to understand. [15.6]

[00:01:15] Oftentimes it’s those short term effects that are overlooked. And those are super important when it comes to keeping the beast away. [8.7]

[00:01:24] And so in this episode we’ll be diving into those in particular, including how to ensure that those short term effects of carbohydrates don’t end up sabotaging your battle to slay the beast once and for all. [14.2]

[00:01:39] But first things first let’s start by celebrating our Beast Slayer of the week. So in each episode of The Miracle Moment we highlight somebody in our Migraine Miracle community who’s recently dealt a mighty blow to the beast. [15.2]

[00:01:55] And this week it comes from an Amazon review from “California Mom. [7.8]

[00:02:03] And so I’ll read her review here, which was posted I think last week. [4.3]

[00:02:08] “Gosh what can I say about this book. I’ve had migraines for years. Five to ten a month. Really horrible. They would last at least three days each in a time.” [9.9]

[00:02:18] “I didn’t even want to live anymore because I figured what was the point. When everyday was so painful I tried everything to get rid of my migraines. [7.6]

[00:02:26] “I found out about this book from the migraine conference and I’m so thankful I did. It’s really really really hard to cut sugar. But the reward is beyond huge.” [9.7]

[00:02:36] The author is a neurologist which gives him instant credibility. As an advanced trained RN, I need to have that research beneath anything I try. [8.6]

[00:02:45] “Now the only time I get headaches anymore is when I mess up. Sometimes it’s hard when you eat out. You have no clue what they are putting in your food. I also feel very uncomfortable asking waiters ‘is there sugar in that. [12.4]

[00:02:58] “As I am thin, I often get harassed about ‘why do you diet so much?’ People are sometimes rude and it’s uncomfortable and unnecessary for me to explain my situation so I don’t anymore.: [10.5]

[00:03:09] “Get this book read it. Change your diet and seriously CHANGE YOUR LIFE. [4.4]

[00:03:14] “You can also consider a ketogenic diet if you don’t know what that is. Google it. I suggest this book to many many people in my world because it is a true treasure.” [8.7]

[00:03:25] So first of all let me say thank you to “California Mom” for this wonderful review and for sharing your experience. [8.4]

[00:03:34] So as she says here she was suffering with chronic migraines for many many years having five to 10 per week that were lasting up to three days at a time, so probably more days than not with a migraine. [15.6]

[00:03:51] As she says, she was wondering even if life was worth living anymore, and now she’s gotten to the point where she’s only getting a migraine when she messes up or deviates from the plan. [11.5]

[00:04:03] She also touches here on some of the challenges that people typically face when making this kind of change. A change that’s different from the status quo especially when it comes to food. [11.4]

[00:04:16] Very few people still appreciate the direct connection between food and health, and just how awful the typical foods people eat, especially the junk that’s often put out in office break rooms and other gatherings, and so people have a hard time understanding why you’re not partaking in that. [20.2]

[00:04:37] And then there’s also the issue of being in a restaurant and trying to find out what’s in your food without feeling like you’re being difficult. [7.5]

[00:04:45] And so learning how to navigate these situations is one of the challenges of adopting the Migraine Miracle plan, but in the end is totally worth the effort and it definitely does get easier over time. [13.2]

[00:04:59] And we’ll also explore this particular topic more in future episodes, including strategies for how to handle some of these common situations. [7.5]

[00:05:07] And I think another thing that’s worth mentioning is that she’s a nurse, which number one means she’s probably had access you know to the latest treatments, and it pretty much everything that’s out there in the conventional medical community. [16.9]

[00:05:26] And, ironically, it’s actually super common for folks in that community not to do well. So I oftentimes find that it’s people in the medical field who are who are many times doing the worst with their migraines. [14.6]

[00:05:41] And part of this is partially a reflection of the demands of that type of work. Doing long shifts and working odd hours. [7.2]

[00:05:49] But another big reason is that people in the medical community often have easier access to all of the available treatments. And the problem with having easy access to all the available medical treatments including migraine medications and so on, is that as we’ve discussed in prior episodes, those treatments commonly make people worse in the long run, turning migraines from an episodic problem to a chronic one. [26.3]

[00:06:16] And moreover, it’s also common for folks in the medical community to kind of buy into the entire system and believe that it sort of has a monopoly on the best treatments, which means that it’s common for people to resist the idea that the standard treatments could actually not be good for them or making them worse. [19.5]

[00:06:36] And I’ve talked about this being the case for myself as well. [2.6]

[00:06:39] For years, I didn’t appreciate just how negatively the migraine drugs were impacting my own health and my own migraines. And since this is the same treatment that I was advocating to my patients, acknowledging that negative impact also meant acknowledging that the treatments that I’ve been advocating to my patients as well had been making them worse off in the long run. [22.3]

[00:07:02] And obviously this isn’t something that’s easy for any health care provider to admit. And the natural tendency is to resist these ideas, which I’ve found to be true of most health care providers. [12.6]

[00:07:15] California Mom says here that she is a highly trained nurse, and so likely had to let go and go through that same kind of difficult process in order to make the kind of progress that she’s made. [14.1]

[00:07:31] I also like the sentence where she says “change your diet and seriously change your LIFE.” As I’ve mentioned before, the changes you make with the Migraine Miracle plan don’t just make a dramatic impact on migraines, the touch virtually every aspect of your life and improve it for the better. [16.3]

[00:07:48] Obviously for anyone with migraines, getting those out of the picture is priority number one. And while I know that the Migraine Miracle plan is the best strategy for making that happen, I also know that it’s oftentimes the other benefits of the plan that ultimately motivate people to stick with it over the long term, and then say they can’t imagine ever going back to their old ways. [22.5]

[00:08:11] That’s certainly the case for me as well. [2.2]

[00:08:15] And speaking of reviews, if you like the Miracle Moment, and you’re listening right now to the podcast version of it or you’ve listened to it before, consider sharing a review in iTunes. Just like the reviews on Amazon, it’s a great way to help other people discover this information. [18.0]

[00:08:33] And for more success stories like California Mom’s, head over to beastslayers.com. That’s where you can also download the Migraine Miracle guide to getting started. [11.0]

[00:08:45] And speaking of getting started with the plan, I recently completed the Beast Slayer Training Academy, which is a course that’s intended to equip anyone, regardless of whether you know anything at all about the Migraine Miracle plan, with the knowledge and the habits that you need to put it into action and slay the beast once and for all. [23.1]

[00:09:09] Over the past few years we’ve learned that those who truly understand the plan and the principles behind it are the ones who end up being most successful. And we’ve also found that some folks were getting started knowing only bits and pieces and those were the ones who tended to struggle. [17.4]

[00:09:28] So I realized that there was a need to kind of provide a comprehensive training resource to help fill in any of the gaps so that nobody would miss out on the critical information that was key to their long term success. And so the Beast Slayer Training Academy is designed to be that comprehensive resource. [17.7]

[00:09:46] It’s broken into six different modules which include video lessons, quizzes, and journal assignments. And it’s designed to take anywhere from about 40 to 90 days to complete. [10.9]

[00:09:57] So it was a lot of work to create but I think definitely worth the effort. Our first group of students in the Beast Slayer Training Academy are now in the final stages of completing it, and the feedback from them has been really great. [13.8]

[00:10:12] And so that’s another resource that’s now included as part of the membership to Migrai-Neverland, which is our premier community for migraineurs, and you can learn more about everything that’s included with membership at mymyigrainemiracle.com/endofmigraine, which is also linked in the show notes. [21.9]

[00:10:35] And also I should mention that members of Migrai-Neverland also have the opportunity to work one on one with me in the Total Transformation Program. [9.6]

[00:10:45] And so that’s something I just launched last month and I’ve really been enjoying the sessions I’ve had with folks. So that’s another something that’s now available as part of the membership. [11.5]

[00:10:57] All right, so now it’s time to move to our topic of the day which is carbohydrates and migraines. [6.2]

[00:11:04] So in broad terms we can think of the typical modern diet as de-stabilising in many ways, creating conditions in the body that our brain wasn’t really built to regulate. And that destabilization creates all kinds of problems straining our system our systems for homeostasis. [20.5]

[00:11:26] And as I talked about in the past, the common thread amongst the most powerful migraine triggers is that they put a significant strain on our brain’s ability to maintain stable conditions inside the body. In other words, migraines are typically generated in situations where our capacity to maintain stable internal conditions inside the body is strained. [23.2]

[00:11:50] Which is why when we minimize that strain it affords us tremendous protection against the beast. [5.7]

[00:11:55] And stabilization ultimately comes down to eating and living like a human, which creates the conditions in the body that our brains are designed to regulate, and removes that chronic day to day stress to the system that puts us at high risk for migraines,and to chronic disease when that chronic and sustained stress to the system causes it to break in various ways. [24.4]

[00:12:21] And I’ve discussed previously that the story of the past ten thousand years when it comes to humans and food is the sharp rise in our carbohydrate consumption. [10.6]

[00:12:32] Initially, that came in the form of grains, and particularly wheat. But more recently in the past century or so that has been accelerated a lot by the dramatic increase in processed convenience foods, with refined carbohydrates including sugar. [16.5]

[00:12:49] And returning to a diet that’s appropriate for a human, which is what the Migraine Miracle Plan is, means essentially eliminating those easily digestible carbohydrates. [10.4]

[00:13:01] Now when it comes to carbohydrates, there are actually two different effects that are important for us to consider, especially those of us with migraines. Those would be the long term AND the short term effects. [12.3]

[00:13:14] And the long term effects of carbohydrates occur when we lower our carbohydrate intake over an extended period of time. So days, weeks, even years, and our primary area of focus there is on the number of grams of carbohydrates we’re consuming per day. [16.0]

[00:13:31] And as far as those long term effects go, there are two ways that they can can benefit us. [6.8]

[00:13:38] So the first, and the central benefit here, is in the reestablishment of metabolic flexibility, or the ability to readily shift between burning fat or burning glucose for energy. [12.0]

[00:13:51] So a sustained high carbohydrate diet leads to what we call metabolic INflexibility, or carbohydrate DEPENDENCE, and prevents you from being able to shift easily between carbohydrates and stored body fat for energy. [15.3]

[00:14:07] And this creates a chronic, daily situation of unstable energy availability. And so metabolic INflexibility is the root cause of things like obesity, diabetes, metabolic syndrome, and it creates a continuous source of stress for the migraineur. [20.1]

[00:14:27] And reducing the carbohydrates in the diet to an amount that’s appropriate for a human is typically the single best thing we can do to restore metabolic flexibility, or again the ability to shift easily between carbohydrates and stored body fat for energy. That results in much greater stabilization in our energy availability. [24.3]

[00:14:53] And this stabilization is typically associated with a dramatic improvement in migraines, which is why the establishment of metabolic flexibility is one of the three pillars for achieving migraine freedom. [13.0]

[00:15:07] Now the precise amount of carbohydrates per day that someone needs to stay under to establish and maintain metabolic flexibility is going to vary from person to person. But the research here indicates that it’s likely somewhere around 100 to 130 grams per day as the upper most limit for most folks. [19.9]

[00:15:28] And then the second way long term carbohydrate reduction can benefit us is through the promotion of nutritional ketosis. [7.0]

[00:15:36] So this was the subject of the last episode, so I won’t cover it again here except to say that significantly reducing carbs in the diet, typically to around 20 grams per day, will stimulate the liver to produce ketones, which our brain can then use as an alternative fuel source. And stimulating the liver to produce ketones in stimulating the liver to produce ketones. [20.7]

[00:15:57] can be another powerful weapon against the beast, and so is another way that long term carbohydrate restriction can be of benefit. [7.8]

[00:16:05] So the establishment of metabolic flexibility, as well as the potential to stimulate nutritional ketosis, are kind of the two primary long term benefits of returning to a level of carbohydrate intake that’s appropriate for a human. [15.3]

[00:16:22] However, the short term, or more immediate effects of carbohydrates – so what happens in the minutes to hours after we eat a meal – are also important to be mindful of. [11.9]

[00:16:34] And that’s going to be the focus of the rest of the episode. And to understand why that’s important, let’s first just kind of review what happens after we eat food that has carbohydrates in it. [11.2]

[00:16:46] So carbohydrates are a class of molecules that contain carbon hydrogen and oxygen, and the ratio of hydrogen to oxygen in carbohydrates is two to one, which is just like water, which is H2O. So another way of saying carbohydrate is “hydrated carbons,” and carbohydrates come in all shapes and sizes, and we tend to classify the carbohydrates in the diet as either simple or complex, with the simple carbohydrates being smaller in size than complex carbohydrates. [34.1]

[00:17:20] And we can only absorb carbs in certain forms. So the first part of digesting any carbohydrate we’ve eaten is to break them down into a form that we can absorb. [11.4]

[00:17:32] And that’s the fundamental building blocks of carbohydrates which are known as monosaccharides, or “single sugar. [7.0]

[00:17:40] And the monosaccharide that’s most relevant to this discussion is glucose, because when we talk about blood sugar, we’re really talking about blood glucose. [9.2]

[00:17:50] And most of this breakdown of carbohydrate and absorption of glucose happens in small intestine. Once glucose is absorbed across the intestine and into the bloodstream, it stimulates the release of the hormone insulin from the pancreas, and then it’s the effect of insulin that drives glucose into the cells of the body so the glucose can be burned for energy. [23.8]

[00:18:15] So that’s a story that some of you may know: carbohydrates hit the bloodstream, insulin is released and carbohydrate is then taken into the cells in use for energy. [10.5]

[00:18:26] But it turns out there are also other hormonal responses that occur after we eat a meal that’s high in carbohydrate. And one of the hormones that’s released in response to a high carb meal is norepinephrine also known as noradrenaline. [16.6]

[00:18:44] And norepinephrine is a hormone that’s released by our sympathetic nervous systemm which is the part of our nervous system that coordinates the fight or flight response, which is a reflex or response that we all have for responding to some sort of threat to our survival. [16.9]

[00:19:01] And so when the sympathetic nervous system is active, or when our fight or flight response is turned on, our heart rate goes up to help get blood to our muscles, our lungs expand so it can take in more oxygen, our digestion slows down so it doesn’t steal energy, and so on. [16.7]

[00:19:18] So here is a picture, or a figure from a study, where subjects were given either a high fat or a high carbohydrate meal, and their levels of norepinephrine in the blood were measured, again an indicator of the fight or flight response. [21.7]

[00:19:41] So there are two lines here, one representing the norepinephrine response over 90 minutes to a HIGH CARBOHYDRATE meal and one to a HIGH FAT meal. [12.3]

[00:19:54] And as you can see from the figure, after a high carbohydrate meal the level of norepinephrine more than doubles, whereas there’s essentially no response after a high fat meal. [13.1]

[00:20:08] So one of the conclusions from the study was that the high carbohydrate meal resulted in and increase in heart rate and sympathetic nervous system activity, features not seen after the high fat meal. [13.3]

[00:20:24] And then here’s here’s a figure from another study where various things in the blood were monitored after subjects were given a carb rich meal. And once again so on the top graph is the release of nor epinephrine, the middle graph is glucose, and then the bottom one is insulin. [25.7]

[00:20:50] So here again we see these big spikes in glucose and insulin, which you would expect after a high carb meal. But we’re also seeing these pretty big spikes norepinephrine, which is like I said an indicator that the sympathetic nervous system, or the fight or flight response, is being triggered. [20.1]

[00:21:11] So essentially each time our norepinephrine spikes in response to a high carb meal, it’s an indication that our fight or flight reflex is being turned on. And so in essence every time our blood sugar spikes, to our body it’s like we’re being chased by a bear, and so if you’re eating a standard Western diet, that’s happening you know at least three times a day. [23.2]

[00:21:36] And as you probably, know emotional stress does the exact same thing to us, it triggers this activation of our sympathetic nervous system, or our fight or flight response that’s really designed to help us respond to a threat, but it’s getting turned on in our modern world in these atypical situations. [21.2]

[00:21:58] And this is kind of the root cause of why both stress and high carb meals are such powerful migraine triggers. [7.9]

[00:22:07] And incidentally if you’ve ever experienced a sugar rush, which I’m pretty sure everyone has, then what you’re experiencing there is your fight or flight response, or your sympathetic nervous system, being activated after a high carb meal because of that burst of norepinephrine in your bloodstream. [16.1]

[00:22:24] And so with the standard high carb Western diet, not only are you having these big swings in blood sugar throughout the day that put us at risk for all sorts of metabolic problems, but it’s also activating that fight or flight response continuously throughout the day. [15.6]

[00:22:41] And as I said earlier, instability is the enemy of migraineurs. Yet, here we have about as unstable a situation as we could possibly imagine. And this instability leads to all sorts of problems, including in the short term recurring bouts of fatigue, and irritability, and poor sleep. [18.9]

[00:23:00] And in the long term, it can overwhelm the systems that we have for disposing of glucose and lead to all sorts of chronic disease. It turns out that our ability to clear glucose efficiently from our blood is arguably the single best metric of our overall health. [17.7]

[00:23:18] And recent evidence shows that this, and not blood cholesterol, is the best predictor of our risk of heart disease. [7.4]

[00:23:27] So if you’re following the Migraine Miracle plan, then you’re more than likely keeping your daily carbohydrate amount in a healthful range. But it’s important to still be mindful of the carbohydrate load of any individual meal, so that it doesn’t produce these short term spikes in blood glucose. [18.6]

[00:23:46] And this is one mistake we sometimes see with people after they implement the plan. So, for example, even if you’re total daily carbs is under your target range, if you were to consume all of those carbs in one meal, it can create a problem thanks to those short term impacts we’ve discussed. [20.8]

[00:24:08] And so the factors that are going to lead to a sharper rise in blood sugar after individual meal are going to be the total number of carbohydrates, how easy they are to digest, and then the less fat or protein and fiber along with it. [18.8]

[00:24:27] So the amount of carbs in a meal, how easy they are they are to digest or to break down, and whether they’re eaten along with other things that will slow their digestion and their absorption are going to impact how much they affect our blood sugar. [17.6]

[00:24:46] Now for most foods you can find their glycemic index, which is a reflection of their short term impact on blood sugar after they’re eaten and digested. [10.4]

[00:24:57] But those only reflect the response when those foods are eaten by themselves, and most of the time that’s not actually what’s happening in real life. And based on what I just said you know that means that the blood sugar response is going to depend on what those foods are eaten with. [18.0]

[00:25:16] So what we’re really interested in is the glycemic effect of an entire meal. [5.1]

[00:25:22] Now, I have a glucometer myself for measuring my blood sugar. So the thing where you prick your finger and put the strip in the meter and it tells you what your sugar is. And for the past several years I’ve measured it before and after eating various things, and so I have a pretty good sense of how various foods and various dishes are going to affect my own blood sugar. [22.4]

[00:25:45] And I also test every recipe that we create for Primal Provisions to ensure that it doesn’t lead to a significant spike in blood sugar. And if it does then we don’t use it. [10.6]

[00:25:56] So yes I literally bleed from my fellow Beast Slayers. [3.5]

[00:26:01] So hopefully that’s a good overview of kind of the different considerations when it comes to carbohydrates, both their long and their short term impact. And now, speaking of Primal Provisions, it’s time for our Primal Provisions PICK OF THE WEEK. [16.1]

[00:26:18] So every week inside of our Migraine Miracle FACEBOOK GROUP we take a poll and see which recipe from Primal Provisions people want us to post. And for those of you that don’t know Primal Provisions is our weekly meal planning service where every Saturday we send out a Migraine Miracle meal plan along with recipes for all the meals grocery lists and prep day instructions for those who want to prepare their meals for the week in advance. [28.4]

[00:26:47] So it’s a real easy way to get started with the Migraine Miracle plan, especially the food part, as it takes all of the planning and decision making off the table and saves you time and anxiety and ensures that you have delicious meals to eat throughout the week. [14.8]

[00:27:03] And so this week’s winning recipe is the Pistachio Chicken with Whipped Goat Cheese Butter. [8.4]

[00:27:13] So this is actually something we make quite a bit around here, partly because it’s so good, and because both the adults and the children in our household enjoy it. [11.8]

[00:27:26] And I think this picture speaks for itself. Like I said above, I test my blood sugar in response to every recipe that goes into Primal Provisions, and you’ll be pleased to know that this dish had zero impact on my blood sugar, meaning my blood sugar was exactly the same before eating it ad at the 45 minute mark. [23.4]

[00:27:49] So I should add that that’s typically when I test because the studies show that that tends to be the time when blood sugar will peak after a meal. [9.1]

[00:27:58] So again this one had zero impact on my blood sugar. So not only by making this recipe do you end up with something that’s crazy good but you’ll also have something that won’t spike your blood sugar or activate your sympathetic nervous system, which as a migraineurs gives me tremendous peace of mind. [20.4]

[00:28:20] So you can find that full recipe at mymigrainemiracle.com/pistachiochicken. [7.8]

[00:28:28] And there you can also download a PDF that you can print out if you’d like to use it while you’re cooking and so forth. [6.3]

[00:28:37] So that about does it for this episode of The Miracle Moment on carbohydrates and migraines. Again if you have any questions on what I’ve covered here, please feel free to ask in the comment section. [15.0]

[00:28:52] And once again all the links I’ve mentioned are available in the show notes. [4.6]

[00:28:57] And if you’re listening to this as the podcast version of the Miracle Moment and you enjoy, it please consider leaving a review in iTunes. [8.7]

[00:29:06] And as a reminder, next week’s episode will air again on Facebook Wednesday at 2:30. And remember you can find this and all prior episodes of the Miracle Moment, along with the written transcripts at mymigrainemiracle.com/moment. [16.4]

[00:29:24] So go enjoy the rest of your day and SLAY THE BEAST! [2.9]

Studies Mentioned:

1. Blood pressure, heart rate and neuroendocrine responses to a high carbohydrate and a high fat meal in healthy young subjects. Clin Sci (Lond). 1990 Nov;79(5):517-22.
2. Impact of carbohydrate-rich meals on plasma epinephrine levels: dysregulation with aging. The Journal of Clinical Endocrinology & Metabolism. 2005 Nov;90(11):6198-6206