Is Paleo for Migraine Right for You?
As a registered dietitian with years of personal and professional experience managing migraine, I can assure you that there is no one “migraine diet.” There are a few approaches that seem to work better and I’m going to share with you where I think paleo fits in so you may decide for yourself.
What is the paleo diet?
The paleolithic diet or “paleo” became very popular about 10 years ago. It was a way of eating inspired by how our ancestors ate during cave man times. The name of the diet inspired many but also drew criticism. Critics typically thought about what is known or assumed about how people ate and lived during the paleolithic er. But, the pioneers in the paleo diet movement, notably Loren Cordain, PhD stated that the paleo diet uses the readily available modern foods to mimic how people ate before the Agricultural Revolution. He was not suggesting that we should literally eat as they did during the Stone Age. Rather, it’s a modern take on diet that is intended to steer people away from foods that are considered to be contributing to today’s modern chronic diseases.
In a nutshell, the paleo diet can be described this way: From the plant kingdom, paleo allows vegetables, fruits, nuts and seeds. It disallows, grains and legumes and sugars. From the animal kingdom, all meats, seafood, poultry and eggs are allowed but dairy is not permitted. The diet is made of mostly whole foods with minimal processing and food additives including salt.
There are many different versions and sets of rules based on the author, blogger or podcaster touting the diet. There is typically a list of allowed foods, disallowed foods and a gray, “sometimes” allowed list. This can often lead to confusion as well as lively conversations around the water cooler about whether or not certain foods “are paleo.” It’s beyond the scope of this blog to discuss this as you can find these debates quite easily in other articles.
My goal is to help you decide if the paleo diet for migraine is right for you.
Later, I will provide some lists and helpful resources to get you started along with some modifications that may help you minimize your attack frequency and intensity.
When is it time to consider significant changes to your diet?
You have probably heard of at least a few foods commonly considered migraine triggers. Can you rattle them off? The ones that are most often cited are red wine, certain artificial sweeteners, chocolate, aged cheeses, processed meats and caffeine.
Assuming you have had worsening migraine attacks for a while, you may have already tried an avoidance diet. I think most people have stayed away from one of more foods on that list for a while. Maybe you currently avoid all or most of those foods. If that’s what you are doing and you are noticing a difference, stick with it. Kudos to you for figuring out some of your food triggers. It’s nice when food is an identified trigger as we can control it. When weather or hormones are the trigger, that’s not possible or far more difficult.
If you have already tried avoiding certain foods and you haven’t seen significant improvement, it’s time to determine what’s next. This is not yet the time to try the paleo diet for migraine. When you have frequent or chronic migraine, avoidance diets often fail. That often suggests that it’s time consider a more significant change in the form of an elimination diet to figure out the dietary antagonists.
The difference between an avoidance diet and a migraine elimination diet.
Migraine avoidance diet
This is when you choose a food or 2 and avoid it for a period of time to see if you notice a difference. For example, someone may have already had a hunch about certain foods in their day -to-day. They choose to avoid wine and highly processed meats for a few weeks to see if they notice a difference. In the process of avoiding those foods, they shift to beer and vegetarian options for lunch. For some people, the avoidance diet helps in a noticeable way and they have figured out that wine and/or highly processed meats are not their friends.
Unfortunately, some people may have avoided those foods and not seen relief from migraine attacks and wrongly concluded that wine and processed meats were not food triggers. What may have happened is they shifted to eating natural alternatives like beer in place of wine and nuts, beans and/or yogurt in place of their lunch meats. They may not have known that the foods they switched to are also considered common migraine triggers even though they are lesser-known as such. Wine, processed meats, may still be triggering foods for them. Sometimes repeatedly trying avoidance diets with a number of different foods leads someone to the erroneous conclusion that they do not have food triggers.
Migraine Elimination Diet
A migraine-oriented elimination diet is unlike an avoidance diet in that you focus on eating ONLY foods commonly considered head-friendly. There is a lengthy list of allowable foods but a surprisingly long list of foods that many do not realize are common migraine triggers as they include some wholesome, healthy foods like nuts, avocados, yogurt and bananas. Alicia Wolf wrote an excellent blog and that gave more details about 2 effective migraine elimination diets. She is an excellent resource for implementing the most popular migraine elimination diet, the Heal Your Headache diet.
Dedicating time to figuring out your food triggers is worthwhile. If you are not already in our private Facebook group called Migraine Strong, I encourage you to join as you consider whether or not you want to try a migraine elimination diet or a different approach. You will find countless people in that forum who have been helped by the elimination diet. There is no one dietary approach to migraine at Migraine Strong as we are all unicorns and have unique solutions to controlling migraine.
Paleo – Clean Eating to “Heal The Gut”
The second biggest mistake I made involved buying a new, shiny red Vitamix. It was nearly the death of me. Armed with my degree in clinical nutrition, I set out to fix my uncooperative head. I was determined to “eat clean,” “heal my gut,” “detox,” yadda, yadda, yadda. Paleo for migraine was my answer! I bought all kinds of “superfood” ingredients and whipped-up nutrient-dense smoothies. I made bubbling cauldrons of potions that I was sure would make me better. Not only did my chronic, daily migraine not get better, I became worse! I gave myself 24/7 pain and the intensity was horrendous on some days.
I was making everything from scratch and spending hours in the kitchen. How the heck did this happen? Shouldn’t I have known? Why couldn’t I figure this out? I’m failed at diet and I was a dietitian!
I had no idea that the fruits and veggies I chose were common triggers. You hear about fermented foods being so good for your gut. Well, they tend to be bad for your head. So, my super-food paleo approach ended with me in tears and finally making an appointment with a headache specialist.
Education is half of managing migraine and I learned this lesson the hard way. Many wholesome, nutritious, “clean” foods are not head-friendly when you are prone to migraine attacks.
The many good things about paleo for migraine
- Paleo is based on whole, minimally processed foods. From the standpoint of managing migraine, this is good as many processed, packaged foods have additives like monosodium glutamate (MSG), MSG-like ingredients and food colorings that some of us with migraine find triggering.
- Since there are no added sugars, people prone to being triggered by fluctuating blood sugar levels may feel better. Both whole grains and refined grains can cause blood sugar levels to rise and fall in some people, so not having grains in the diet can also be helpful.
- For some people, sugar and grains tend to cause inflammation. If inflammation is part of what contributes to migraine attacks or overall sense of being unwell, the paleo diet may help.
- The same can be said for dairy. If dairy is inflammatory following the paleo diet may be helpful. I’m super-happy that dairy is not inflammatory for me and it might not be for you, either.
- Paleo consists of mostly wholesome, nutrient-dense foods. There are no “empty calories.”
- Shifting away from highly processed foods usually means that most people will get the benefits of having more fiber in their diet. Additionally, their sodium intake will likely be much lower than it had been and they may see benefits from reducing their sodium.
The potential negative aspects of paleo for migraine
- Unless someone is aware of wholesome foods that are common migraine triggers, they may feel worse.
- Depending on a persons’ food preferences and choices, they may choose sugary, high-carb fruits too often and cause fluctuations in blood sugar thereby potentially triggering migraine or feeling unwell.
- While there are good, non-dairy sources of calcium, Vitamin D and other nutrients associated with dairy products, the paleo diet may not provide enough depending on food choices.
- Paleo requires a lot more planning, preparing and cooking than many people are used to doing. Someone with frequent or chronic migraine may not feel well enough to do what it takes. It was hard for me!
- Hunger and cravings. Personally, I was always hungry. Looking back on how I implemented paleo, I made the mistake of drinking smoothies and having too much fruit. In an attempt to satisfy my sweet tooth, the carbohydrate load from the smoothies and fruit I was eating probably made me constantly hungry. Scratch that. I was HANGRY. The hunger and cravings on top of worsening migraine symptoms did not make me a fan of paleo for migraine.
- Salt. It’s anecdotal, but I have noticed that many people that I have encountered in the migraine community have low blood pressure or blood pressure that is in the lower but normal range. I have also noticed that many people specifically find comfort in salty food and migraine relief from caffeine. Caffeine is a part of some combination medications specifically prescribed for migraine. Both salt and caffeine can increase blood pressure. Perhaps, the sodium intake in paleo is too low for some people. This may be part of the reason I felt so awful.
5 Questions to ask yourself about the paleo diet
- Am I willing and able to do the required planning and cooking?
- Is a diet without grains, sugars, legumes and dairy sustainable for me?
- Do I know my food triggers?
- Can I plan a well-formulated paleo plan so that I am getting all the nutrients I need?
- Do I have a supportive community to help keep me motivated and on-track?
My opinion of paleo for migraine
There are a few diet approaches that we favor at Migraine Strong. In Alicia’s blog, migraine elimination diets are discussed as well as the ketogenic diet. This approach is supported by many headache specialists. In many Facebook groups, including our own closed Facebook group, we see countless examples of the diet working. Identifying triggers can significantly help you control your attacks and that is why we advocate it and give lots of support for those giving it a try.
The keto for migraine approach has evidence to support it’s use. I’ve written about why I like keto and how to get started with keto as well as get to the point of keto-adaption. A big benefit of the keto diet is that it suppresses your appetite and cravings making the restrictions much easier to follow.
While there are a lot of positives about paleo for migraine, I prefer to guide people toward migraine elimination diets first to discover triggers and see if that’s enough diet intervention needed to get them to feel better. Wouldn’t it be nice to figure out that you can get 50% better by figuring out your main food triggers? What if those triggers were only yogurt, bananas and raw onion? What if it was protein powder that you have using for years? Having “ah-ha!” moments” that bring about relief is so nice to witness each week. Food triggers are within our control whereas most other migraine triggers are not.
I will also continue to suggest keto for migraine over the paleo approach as I believe there is something almost magical about ketones for some of us. There are studies underway to help us understand why being in nutritional ketosis helps. Having more ketones in our circulation from MCT oil without being in nutritional ketosis is also being studied. This will certainly be a topic for a future blog.
When paleo is not modified for common food triggers you may feel worse, as I did. Additionally, without the appetite suppressing effect of being in ketosis, sticking with the restrictive diet may be too difficult. And, there may be something about salt that helps those of us in the cranky neuron club feel better and nearly all paleo diet guidelines discourage salt.
For those of you who have answered “yes” to the questions above, you may be ready to take on the paleo diet even though it’s not my favorite. It’s ok. My feelings aren’t hurt. You can skip the migraine elimination diet and keto and go straight to paleo if you wish. And, if you are in our Facebook group we would certainly support your efforts. We love when people try diet as a way of feeling better. Here are my suggested steps.
5 Steps to the Paleo for Migraine Diet that Works
- Educate yourself about the diet. There are many, many resources.
- Know the common migraine triggers and cross them off of the allowable list. A simplified list is below for your convenience.
- Plan to start the diet when you know you will have time to commit to preparing your meals at home or you know you will have a lot of control over food choices when eating outside of the house. The Dizzy Cook blog has an entire section dedicated to paleo recipes that do not have the common trigger.
- Find a supportive community for ideas and inspiration. You won’t have to look far to find plenty of them in social media.
- Track your attacks as well as suspected triggers in an app like Migraine Buddy so you notice patterns. This is an important part of figuring out if what we are doing is helping and worth the effort.
No matter which diet approach you take, good for you for taking control of this aspect of your health. There is so much you can do to help get yourself better along side of your doctors. Always do your own research including consulting with your doctor about changes to your diet. The above is not medical advice.
We love to hear from you! Feel free to share your thoughts and experiences about this topic in comments section.