Intermittent Fasting for Migraines

I started out my alternative health journey in 2019 with the keto diet, which is a high fat, moderate protein, and low carb diet that has been shown to have neuroprotective benefits and is being studied for the treatment of conditions like Alzheimers and migraines. After being on the keto diet for 6 weeks, I decided to add intermittent fasting to the mix.

Why Fast?

There are a lot of known, scientifically backed reasons to fast including regenerating stem cells, increasing BDNF (brain derived neurotropic factor), autophagy (cell spring cleaning), reduced insulin and reduced blood sugar, and weight loss. Studies have shown that those with migraines have higher insulin levels (ie. insulin resistance) and impaired metabolic pathways when it comes to processing glucose (ie. carbs). To tackle my ongoing headaches, I decided to approach it from the perspective of becoming metabolically stronger and leaner as being overweight has also been linked to increased headaches.

Some ways that fasting might help those with headaches include lowering insulin and blood sugar, weight loss, and protecting the brain with increased BDNF and the potential to generate brain stem cells.

Intermittent Fasting: 16-24 Hours

In the beginning, intermittent fasting was pretty tough for me probably due to some bad insulin resistance. I often would get shaky, dizzy and hangry when going more than 6 hours without food, so fasting for 11-12 hours was hard.

Intermittent fasting means fasting for 24 hours or less and practicing what is called “time restricted feeding.” Which means, you might decide to fast for 16 hours with your last meal your dinner on day one, then break your fast with lunch the next day. You would then eat all of your meals within an eight hour feeding window. There are a lot of different feeding windows people practice – 16/8 is known as the Lean Gains method (fast 16 hours, eat within 8 hours), 20/4 is known as the Warrior Diet (fast 20 hours, 4 hour feeding window), and 23-24 hours is known as the OMAD diet (one meal a day). Personally, I find trying to eat 1300+ calories in an hour way tough on my digestive system, so I like a feeding window between 4-6 hours (also, two meals a day means less food prep, which is great!)

After fasting for 11-12 hours every day for 2 weeks, my body began to adjust to the regimen. At first, I was feeling pretty dizzy, lightheaded and tired, but over time, those symptoms decreased. I started to slowly increase my fasting time, until I was fasting for 16+ hours. I even accomplished a 24 hour fast! However, I did have irregular periods during the first 3 months of fasting, although eventually my body adjusted.

After fasting for 5 months, I found fasting for 16-18 hours to be fairly reasonable, and breaking the fast within this timeframe meant I wasn’t particularly hungry and had good energy for the rest of the day. Most of my fasts started in the evening and ended midday. Fasting more than 18 hours often interrupted my workday and productivity as I would feel tired and hungry and unable to concentrate on work tasks.

Extended Fasting  (Prolonged Fasting)

After intermittent fasting for 5 months anywhere from 16-24 hours a day several days a week, I decided it was time to experiment with an extended fast of around 60 hours. Any fast beyond 24 hours starts to drift out of the realm of intermittent fasting to extended fasting. This fast wasn’t too tough, although I knew I wouldn’t be doing too much throughout the fast besides resting and light activities. A few benefits that come with extended fasting over intermittent fasting are autophagy, stem cell regeneration, increased growth hormone and BDNF.

I chose a quiet weekend as one thing I had been worried about with an extended fast was not sleeping well. However, both nights of the fast, I slept relatively fine although it took a little longer than normal to fall asleep.

On the second day of my 60 hour fast, I made the mistake of drinking a ton of coffee and walking around in the hot sun running light errands without water for hours. I came home with lots of headache pain and no amount of water, salt and strength training could nip the pain in the bud. I ended up having trouble falling asleep due to the headache!

On the third day, I broke the fast with some bone broth, and an hour later, a light meal of eggs and avocado. Overall, I felt great, although I spent the next week with a bad migraine. I knew I had messed up with the fast being too stressful and not being hydrated enough! The peak of the fast for me was at the 36 hour mark, when I felt lots of energy and was in a great mood. Another surprising result of the fast was having a heightened sense of smell during the fast (the world smelled delicious!) and bad keto breath for a week after the fast.

After the 60 hour fast, I gave my body a month to recuperate. I was still having more migraines than normal, so I decided to do a 36 hour fast to see if it might help with my headaches. While I had headache pain during this fast, I drank way more water and salt than my previous 60 hour fast and after the first 24 hours, the headache was gone. I slept extremely well (much better than normal) and fell asleep faster than my first 60 hour fast. I woke up feeling in fairly good energy and in a great mood with no headache pain. After breaking my fast, my daily headache symptoms did not return for a week!

Experimenting with extended fasting taught me the right length of time to undertake a longer fast to treat a headache (rather than cause one!) However, the only way I could get to the point of being able to do a longer fast at all was regular intermittent fasting of 16-24 hours for months before I undertook an extended fast. After my 60 hour fast, I noticed that fasting for 22-24 hours was easier than before.

What time of day should you fast? Evening to Morning? Morning to Morning?

When I first started out fasting, I began each fast in the evening after dinner around 6-8PM. I ended my fasts generally midday and skipped breakfast and much of the fasting happened overnight while sleeping. As I am prone to experiencing a lot of hunger in the evening and at night, I found it easier to start my fasts after eating dinner in the evening. However, one downside for me was being in a fasted state while trying to do work tasks the next day. By the time I hit 17-18 hours of fasting around noon or so, I feel pretty hungry and tired and unable to work on my day to day tasks.

Recently, I decided to experiment with fasting starting earlier in the day (around 3-4PM) and ending shortly after waking. It was tough ignoring the evening hunger the first three days (my stomach grumbled nonstop from 6-10PM each night the first three nights!) But after three days, the hunger decreased substantially. This schedule has worked out much better with my productivity, as ending the fast in the morning means not working in a fasted state so I have better energy and focus. I find it easier now to fast longer as I can break the fast after a morning workout at lunchtime, and get to work on my business tasks! I wake up with much higher ketone levels than before, and can get away with eating a little more carbs than previously.

Many people find that fasting gives them heightened senses and concentration, but I find that doesn’t happen for me (yet)! Perhaps when my insulin resistance is better, fasting and working at the same time will work out better. My only regret is not ignoring the fasting hype sooner, and taking so long to listen to my body and change my fasting schedule to be more productive. There is a lot of hype around fasting being a cure all for anything!

Should You Fast?

The keto diet is a great way to get many of the benefits of fasting, without actually fasting. I am not a medical expert, so I can’t say if you should fast or not.  Fasting for me was goal dependent. I wanted to increase my insulin sensitivity faster, keto will get you there halfway while fasting will boost that another 50%! There are also health benefits with fasting that you don’t quite get with keto related to aging, longevity, neuroprotective, etc. When it comes to chronic medical conditions that are autoimmune (headaches included), experimenting with fasting could be a game changer.

I started off both the keto diet and fasting from a very metabolically weak place. It has taken 6 months to become metabolically stronger, and much of that time has been spent feeling tired which has not been great for my productivity. So it all depends on your goals, if you have the leeway to scale back your day to day activities then keto and fasting could get you stronger faster. I am only just now starting to find fasting past 18 hours easier, and am only now after 6 months able to work and do more activities during longer fasts whereas previously, I often needed to rest much of the day.

Ultimately, experimenting with what works for you is the best way to go when it comes to fasting (even choosing to not fast if it doesn’t work for you!) There is not enough research to clearly determine how much one should fast, and how long to fast, so it’s best to listen to your body and how you feel when experimenting with fasting.

Fasting, Keto and My Health – Blood Tests

I recently had blood work done to see if the keto diet and/or fasting have made an impact on my cholesterol. I also had my a1c and fasting insulin levels checked. I am happy to report my cholesterol is completely normal and my triglyceride levels quite low. A small percentage of people who undertake a keto diet find their cholesterol levels shoot up, it’s unknown if this is a good or bad thing. You can learn more about cholesterol and the keto diet from this Perfect Keto podcast episode.

The a1c blood test checks your average blood sugar over the past 3-4 months by measuring how much sugar is “glycated” on your red blood cells. While my a1c level was good at 5.2, and my fasting insulin was decent at 8.6, I know I want to see those numbers go down even more and that I probably am still mildly insulin resistant. However, getting blood work done always ends with me getting a migraine, so it’s likely I won’t be doing any more blood work for at least 3 more months. I wish I had done all of this bloodwork at the start of my keto journey so I could be now seeing clear results (who knows what these numbers were 6 months ago, they were probably quite higher!) If you are interested in having blood work done, you can request tests online and stop by a local private lab for the work (I paid out of pocket). You can learn more about the myriad blood tests you can have done from this Keto Talk podcast.