In part 1, I covered the basics of the “Starve and Sink” approach to ending a migraine without a pill (click here to listen to that episode). In part 2, I cover some of the Frequently Asked Questions we’ve received over the past couple of years about it.
The “11 Drug Free Ways To End A Migraine” article: mymigrainemiracle.com/drugfree
The Intelligence Unshackled Podcast – optimizing brain health and function
The 2019 Schedule of Migrai-Neverland Challenges: https://mymigrainemiracle.com/schedule
The 9 Primary Migraine Miracle RESOURCES: mymigrainemiracle.com/how-we-can-help/
MIGRAI-NEVERLAND, our premier resource for those who want to find their pill free path to migraine freedom (including the Beast Slayer Training Academy): mymigrainemiracle.com/endofmigraine
Migraine Miracle Facebook group: https://www.facebook.com/groups/899131986822364
The book that started it all – The Migraine Miracle: https://www.amazon.com/Migraine-Miracle-Sugar-Free-Gluten-Free-Inflammation/dp/1608828751
Howdy, folks. So in this episode, this is going to be an extension of the last episode, or part two on the starve and sink method for ending a migraine. So if you haven’t heard that episode, again, it’s the one right before this one, you might want to listen to it first for a little background, because today I’m going to be covering frequently asked questions about starve and sink.
As I talked about in that last episode, this has been a very hot topic in our Migraine Miracle community. Since I put this out there a few years ago, lots of people have put it into action with great results. Based on those experiences, including many of our Migrai-Neverland members, we’ve continued to learn a lot about it. This has been a common topic of conversation in our clinic chats, which is our weekly group coaching sessions inside of Migrai-Neverland. We’ve learned a lot from each other about the starve and sink it, so in this episode I’m going to be sharing some of those questions that consistently pop up.
Also, this starve and sink is one of the 11 drug free strategies for ending a migraine that I wrote about in the article entitled 11 Drug Free Strategies for Ending a Migraine. You could find that full article at mymigrainemiracle.com/drugfree, also you can download our migraine drug free survival guide on that page as well. Before I get to those frequently asked questions, just a little bit of housekeeping. Our next 30 days challenge for Migrai-Neverland members will launch this Saturday that is April 13th. This is going to be our 30-day sleep challenge.
So this is the first time we’ve done a challenge on sleep, and I’m very excited about it. It’s hard to argue that there’s anything more important to our health or to migraines in general than sleep. It’s also one of those things, like rebound headaches, that if sleep isn’t working then nothing is going to work. It’s an absolutely necessary foundation for everything else, and of course it’s also an area where our modern lives, and a mismatch between our modern life and our ancestral life really creates some significant issues. However, it’s also an area where there’s been a lot of research in the last couple of decades that’s come with a lot of actionable advice on ways we can minimize the impact of that mismatch and get better sleep, get better both quality and quantity sleep.
So there’s lots we can do to minimize the impact of the modern world. Not just on the quality of our sleep, but also things like circadian alignment, which is extremely important to our health and to migraine prevention. So like all of our other challenges, we’ll be aiming to educate ourselves, and to establish some new habits that we know are associated with better sleep quantity and quality, and to use each other for accountability in doing so. As I’m sure you know, the solution to better sleep is not through drugs, despite what the TV ads might say. And in fact you can make a very strong argument that the drugs for sleep and insomnia have been a huge net negative on the whole, and they’re one of the main reasons why people have so much trouble sleeping.
Same exact reasons why the drugs for migraines lead to more migraines. The drugs that are used to treat insomnia ultimately trade a short term benefit for a long term problem. So, we’ll be talking about all the ways to improve our sleep that don’t involve taking a pill that work with our body not trying to disrupt it. And I’ll also be combining this challenge with a book club selection. Of course, this one is going to be on sleep, we’re going to be reading the book Why We Sleep by Matthew Walker, which was recently published, and has been a best seller, and it’s an excellent book. So we do these book clubs periodically in Migrai-Neverland, and we’ll do this one in tandem with the challenge, with the sleep challenge.
So, we’ll read the book together, discuss it along the way, and then at the conclusion of the challenge, we’ll have an entire clinic chat dedicated to discussing it. Again, I can’t emphasize enough how important sleep is for migraines and how important it is to be mindful of getting the best quality sleep possible. So if you think there’s room to improve your own sleep, or if you want to learn about the latest research, then we’d love to have you as part of that challenge and as a member of Migrai-Neverland. All of the challenges are available again to Migrai-Neverland members.
There are a couple reasons why we do these challenges. The first is that, on a personal level, I consider The Migraine Miracle Plan to be an ongoing process. So I’ve talked about the three pillars of migraine protection, and the ways that we can build those three pillars, which are eliminating rebound, establishing metabolic flexibility, and reducing mismatch foods and behaviors. And that’s a process that really is ongoing always. There’s always areas where I can improve. So I use these challenges personally as an opportunity to continue to improve and to do that with the support of a group, and the hope is that everybody else in the group will do that as well, and will also see this as a lifelong effort.
The reason is not because I’m some disciplined health nut, it’s because every time I do something to improve this process, to build the three pillars, I just continue to feel better and better. So keep getting more and more results that reinforce that this the right path. Another reason for continuing to do these challenges, and for repeating ones on the same topic multiple time like our keto last challenge is that we’re learning new things all the time. So these are areas of active research, and they’re areas where there are people all around the world putting this into action. And each time we do this, we learn new things that we can then incorporate the next time around.
So, just as you would go out and practice your golf swing over and over again to keep getting better, this is a way for us to continue to improve and to continue getting better and to incorporate new ideas and new research as they come out, and to add in our collective experience and improving the results for everybody. So if you want to see what our full schedule of challenges is for this year, you can go to mymigrainemiracle.com/schedule. Of course, if you want to learn more about becoming a member of Migrai-Neverland, you can go to mymigrainemiracle.com/endofmigraine or you can just go to the website and click on the resources tab at the top of the menu.
Also, if you like this podcast, once again, it’d be awesome if you left a rating or review in iTunes. Thanks again to the many of you who have already done so. It really does mean a lot, it really does help other people find this podcast, and find out about the migraine miracle plan. Remember that if you screenshot your review and email it to me at [email protected], you’ll be entered into our drawing for a Beast Slayer shirt, and a signed copy of the book, The Migraine Miracle. And I will also read your review here on the podcast.
Speaking of, here’s a recent review that comes from sdkellam on iTunes, which says, “Great podcast, offers hope, understanding, connection with a community, and a new way forward for all of us migraineurs. And fascinating too, not just regarding health, but also culture and even the history of biological evolution.” All right. So housekeeping out of the way, let’s get to some frequently asked questions about the starve and sink strategy for ending a migraine.
Hey, folks, if you like The Miracle Moment Podcast, there’s another podcast that I host that you might enjoy as well. It’s called Intelligence Unshackled, and it’s all about optimizing the health and function of the brain. So it covers the many things that we can do to improve our cognitive function in the here and now, as well as to protect ourselves against cognitive decline and dementia over the long term. The good news here is that if you’re already following the migraine miracle plan, then you’re way ahead of the game already. You can find the podcast by searching Intelligence Unshackled, or just by searching my name Josh Turknett, T-U-R-K-N-E-T-T in your podcast app and then clicking on the subscribe link.
I’ve also put a link to the podcast in the show notes for this episode as well. Also, I know that many of you are looking for ways to encourage friends and family, who don’t suffer from migraines, to change their diet and lifestyle as you have in order to reap the many other benefits of doing so. And sharing this podcast with them is a great way to do that, since the focus here is on keeping our brain in the best condition possible, which is applicable to every human being. So again, I invite you to check out The Intelligence Unshackled podcast.
If you haven’t heard, again, part one on this series where I introduced the starve and sink method, I’d suggest going back and listening to that first. The basic gist here is that the starve part refers to depriving the beast of energy during a migraine, or avoiding an energy surplus by fasting. Then, the sink refers to doing some form of physical activity with the sink metaphor here to describe the idea of diverting energy away from the beast. So we’re doing things here to accelerate the beast demise, to end the migraine faster.
So the first question is when should I implement this? Will it not work if I don’t do it early? The short answer here is that you can implement this approach anytime. I know that a lot of migraineurs have been told over the years that they have to take their medications early in a migraine, or else it won’t work. So I think this question probably is an outgrowth of that idea that there might be a critical window beyond which this approach is no longer helpful. But I don’t think that’s true at all. And I think the most helpful way to think about this approach is simply to understand that the beast will survive, or the migraine will survive longer with food in your system than without. That’s basically all there is really to remember, and that’s the key principle.
Anytime you add food or energy into the system, you’re creating an energy surplus, which as I discussed in the last episode is something that’s associated with migraines. The absolute worst thing to eat of course are carbohydrates, especially processed or refined carbs, which will lead to a rapid energy surplus. So I see fasting essentially as a means of getting through a migraine in the shortest time possible without a drug. Of course, on the flip side, eating during a migraine will prolong its duration.
The next question is what should I eat when I break the fast? So when you’re deciding to eat again, or when you’re breaking your fast, I’m generally going to aim for something that’s going to be absorbed relatively slowly, and have a negligible impact on my blood sugar. So that means typically something fairly high in protein, as well as things like fibrous plant matter, not starchy stuff, but fibrous vegetables. My personal go to here are eggs. Usually scrambled, but hard-boiled would work as well. You can also throw in some greens like spinach, or kale, or some fibrous plant matter that’s very low carb.
I would also use a liberal amount of salt during this first meal, because just as with a ketogenic diet, or the transitional phase to keto, fasting tends to be associated with some fluid and mineral losses, so I want to make sure that I’m repleting those minerals with my first meal. Another thing you could eat would be roasted or grilled chicken. Again, high protein, and again maybe with some greens or a salad. I would generally avoid using anything in this situation with purified fats, as again I want the gentle addition of energy to the body, and purified fats, even the good ones like coconut, avocado and olive oil, will add energy more quickly since they’re energy dense and they have been pre-processed to a degree, which will make them easier to digest, so a more rapid addition of energy into the system.
This is an important principle to keep in mind. Virtually anytime you’re altering a plant or an animal food from its state nature, you’re essentially pre-digesting it to a degree. So you’re essentially outsourcing some of the breakdown of that food, which will then reduce the amount of time it takes you to break it down and digest it once you eat it. This is one of the big problems actually with all of the gluten free substitute foods out there. Like the gluten free breads. But even all the snacks and treat recipes for keto and low carb that people post about with all manner of substitute flowers. So yes, you may have removed one potential issue, or reduced the amount of carbohydrates, or removed some of the plant toxins, but you’re still eating a processed product that’s far removed from anything available to our ancestors.
So I definitely would avoid any of those sort of gluten free substitute foods. Something like sardines would also be another good option here. Many of the items actually that are on our migraine super food list, which is part of our Beast Slayer Training Academy, would be a reasonable candidate here.
Another question that we get is how long should I fast? So, during the starve and sink experiments that I talked about in the first episode, my strategy was simply not to eat if I had any hint that a migraine was brewing, and then to just eat once it resolved. So pretty simple. And I said in that episode that one of the most remarkable things about this was how consistent the progression of symptoms were during each migraine. So, what seems to be happening is that by not eating, by not taking any medication, I was basically taking the two major variables out of the equation, and those two variables apparently are why migraines tend to vary so much between one and the next.
I would say that my average fast was just short of 24 hours, and that’s been a pretty consistent time frame that a lot of people report. Now I will say that I have been doing the migraine miracle plan for quite a while before doing those experiments. Meaning that I was well fat adapted and metabolically flexible and I also wasn’t dealing with rebound really anymore. So by that point in time, it really wasn’t hard to do a 24-hour fast, like I said I was well fat adapted, and especially easier if you throw a migraine on top of that. But there may be times when it’s longer. I think the longest that I’ve fasted as part of the starve and sink at least was five days. But that was after a migraine that had been induced by a really bad bout of flu, and possibly even a mild case of aseptic meningitis.
But it’s generally recommended not to fast outside of medical supervision for more than 72 hours, and debating whether or not that’s a reasonable recommendation is beyond the scope of this podcast. But that’s kind of the general guideline. Of course, all of the usual caveats that apply to any type of help education information applies here. So this is for informational purposes only, and should not be construed as medical advice. If you have any concerns about fasting or how long to fast, then you can also consult your doctor. But again the basic take home message here is that my personal approach is just fast until the migraine is gone.
But also, it’s worth mentioning that I think the sink part of this, the physical activity, is optional. So I see that as a way of accelerating the demise of the beast, but I see fasting as the primary tool. Simply because eating will prolong the life of a migraine.
The next frequently asked question is, is this a useful strategy for rebound headaches? First, let me clarify the terminology here a bit. As you’ve probably heard me talk about before, one of the problems with rebound headaches is that the way in which we’ve typically talked about them is very misleading. So most of the time, rebound headache is a diagnose, it’s given when someone has reached the point of having a chronic unrelenting headache that won’t go away, and it’s from the use of the abortive medications. As I’ve discussed, the perception this gives is that the abortive medications aren’t causing any problems until you’ve reached that point, which as hopefully you know is entirely the worst way to think about it.
The more helpful way to think about it is that each dose of medication we take to try to end a migraine renders us more vulnerable to a migraine in the future, and in the prior podcast I talked about the future of migraine risk score that you could think about any drug having, so every drug raising your future vulnerability to another migraine by a certain amount, and for a certain length of time. And if this process continues to compound over time, if you keep taking medication, then we may reach a scenario where we’re so vulnerable that the headache just doesn’t ever go away. That means that until the body has restored a sort of pre-medication equilibrium, a process that may take six months or more from the last dose of medication, then the abortive drugs are still contributing to some degree to migraines.
But that being said, the longer you go since the last dose, the less that contribution becomes. But the answer to the question does this approach help with rebound is absolutely yes. Because rebound is just another face of migraine. It isn’t something fundamentally different, it’s just a migraine process that’s just set in and won’t go away. Oftentimes, rebound headaches will accentuate certain aspects or characteristics of a migraine, and this seems to depend on a particular medication that’s led to that rebound headache. So the rebound headaches of triptans for example tend to have different characteristics than those of non-steroidal anti-inflammatory medications.
That’s likely a reflection of the part of migraine physiology that those drugs target. So triptans for example may target the vascular elements and so the symptoms that are caused by those parts of the migraine process are generally amplified when someone is in a rebound headaches there are primarily the result of triptans. Then the non-steroidals target the inflammatory elements of a headache. So then the symptoms that are a result of inflammation are generally amplified with rebound that’s primarily the result of non-steroidals. Then of course, if it’s been multiple medications that’s led to that, then you have all of these elements together.
Again, the point being that this is all still part of the migraine process. It’s just certain features being amplified depending on the particular drug that has been taking over time. So, suffice to say that folks have definitely used the starve and sink to great effect in helping with accelerating their recovery from rebound. There are a couple of things to keep in mind, one is that the natural history of rebound headaches are longer than the natural history of a single migraine. So as I’ve talked about, some folks take the cold turkey approach to getting off of the abortive drugs, and some people take a more gradual approach trying to just space things out over time.
For those taking the gradual approach, the starve and sink can be a way of really helping to space out those doses of medication, or just prolong the time between one dose and the next. The other thing to keep in mind is that fasting becomes much easier to do once you’re fat adapted and metabolically flexible, meaning that once you’re able to easily mobilize stored body fat from your fat tissues when you haven’t had a meal in a couple hours or so. If you’ve been eating a standard Western diet, it’s going to take some time for the body to get into that state. So if you’re still getting really hungry in-between meals, or you feel the need to eat every few years, then you’re definitely not fat adapted yet.
If the idea of fasting for 12 to 24 hours seems preposterous to you right now, then you’re definitely not fat adapted. So it may be reasonable to allow some time to adapt to the diet changes, to allow that metabolic machinery to kick in before adopting the starve and sink approach.
Then, the last frequently asked question I’ll cover is why does this work? So, I did cover a couple of potential explanation in the last podcast as to why this may work, the starve and sink approach. Of course, this is speculative. But it’s based on some established research with respect to migraines and metabolism. So in the last episode, I gave two potential reasons. The first being that migraines are thought to be a condition of excess excitability in the brain, or hyper excitability. And that the excess excitability is promoted or amplified when there’s an energy surplus in the body. That energy surplus is created every time we eat. So not eating kind of keeps us in energy equilibrium.
Then the second potential reason, [inaudible 00:22:08] there’s evidence of blood brain barrier breakdown during a migraine. So when that happens, stuff that shouldn’t get into the brain from the blood stream does get in, which then can promote inflammation, which would then further strengthen and amplify the migraine process. So if we’re not eating, we’re not placing any foreign substances into the blood stream that could then make their way into the brain and worsen the inflammatory process.
Another possible reason is that, as you might recall, the body starts producing ketones during a fast. So generally it takes about 16 hours for this to start to happen. So another way that this could be helping is through the production of ketones in the liver, which can then exert anti-migraine effects on the brain. And I think to sum all of this up, the key takeaway really is that fasting promotes metabolic states in the body that we know are associated with protection against migraines.
All right. So that wraps up this episode of frequently asked questions about the starve and sink approach to ending a migraine. If this sparked any additional questions, feel free to ask those in our Facebook community. And if you’d like to ask me directly in any of our group coaching sessions, which we do every week, about the nitty-gritty details of the starve and sink or other aspects of the Migraine Miracle plan, or migraine treatment, or nutrition, and so on, then I’d love to have you there as part of our Migrai-Neverland family and as a reminder, as I mentioned in the opening, we will be starting our sleep challenge in just a few days this weekend. So really excited about that.
Again, you can learn more about all of the resources that we offer by going to mymigrainemiracle.com and clicking on the resources tab on the top menu. All right, once again, thanks so much for listening. Now it’s time to go out and slay the beast.