calorie deficit and migraines

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I don't know if this is a common problem, but if I am in calorie deficit it triggers a migraine, sometimes bad enough to make me vomit. After the worst is over, usually after 2-3 days, I go into a feeding frenzy - it's like my body knew it needed sugar, and now it seeks it out. Oddly, once the migraine is established, eating won't help. But the feeding frenzy doesn't know that, I just crave the carbs and believe me, while I'm recovering from a migraine, the craving is all-consuming. I have a tiny window when the pain starts where I might avoid the migraine by eating, but once the pain is there, nothing helps. The calorie deficit could be from missing a meal, or it could be not quite enough calories over several days. No drugs have helped.

Obviously this makes losing weight a challenge. What I want to do here at MyFitnessPal is keep track of my calories and see if there's a cut-off where I know for sure if I don't eat I'll trigger a migraine. Or, is there an ideal combination of macronutrients that protect against it. If I am under a lot of stress, that protects against it- maybe because of the adrenalin? But I'm not an anxious person, usually, so I'm rarely that stressed. I'll also record exercise and see if that has any effect - I get extra hungry when I work out, so possibly the exercise could be putting me at risk too. I'm still going to exercise, but I may have to make sure I account for that in my eating for the day.

Although it would be nice to lose the extra 25 pounds I'm carrying around, I don't have a lot of hope, because of this issue and because since menopause I feel lucky when I just don't gain more weight. If it happens great, but for now, I just want to not have migraines. My friends don't really understand, they just think, "Well, don't NOT eat!" But they are not taking into account that everyone with a normal life eats more one day, less the next. Life happens, you have meetings through lunch and then don't get to eat, or whatever. I will always need to plan more carefully, but now I am trying to approach it more scientifically and see if there's a math to all this, or if there are too many variables to plan for.

Anyone else out there with this problem? Lots of people get headaches when they cut back calories, but that's not the same as a migraine.
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  • L1zardQueen
    L1zardQueen Posts: 8,754 Member
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    Do you get migraines when you are eating at maintenance level?
  • Fflpnari
    Fflpnari Posts: 975 Member
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    Whats your calorie goal? height weight age. Have you made diet changes or just cut calories?
  • vbriz25
    vbriz25 Posts: 20 Member
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    Hi @EmpressBarbara

    If before your calories intake was more than 2500-3000, try to reduce slowly while you can identify the amount of calories that works for you.

    Ensure your macros ratio is the adequate for you. Normally the macro ratio is Carbs 50, fat 30, protein 20. (if your condition is preexisting check with your doctor or nutritionist).

    Don't set your calories deficit goal so fast.... Reduce progressively while your body is adapting to the new calories intake.
    Ensure you are drinking enough water. Do your workouts accordingly to your wellbeing.
  • yirara
    yirara Posts: 9,420 Member
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    What is your calorie allowance and how much do you have to lose? It might be too little for you
  • cmriverside
    cmriverside Posts: 33,992 Member
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    Well if it's true migraine, that is a pathology all its own and you'll need management - I had chronic migraines for 25 years until I went through menopause and they were disabling...so I feel your pain.

    I had so many things I thought were triggers and tried all kinds of things, there were a few specific foods that caused an onset.

    I just had to rely on pharmacology. I tried everything else, but migraines were affecting my ability to keep a job by the time I just learned to take the triptan at the first sign of migraine. Maxalt is what I settled on, it dissolved on my tongue and was quick and without other side effects. I was on five different anaphylaxis meds that I took every day, too.

  • EmpressBarbara
    EmpressBarbara Posts: 18 Member
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    I'm actually not sure what my maintenance level is - but I am going for 1800 - 1900 calories to see where that gets me (more on workout days). According to the Harris Benedict equation, I need 2099 calories to maintain on a "slightly active" day. But math is one thing, real life is more complicated. This is a new experiment, I'll need many days of observations.

    Before menopause, if I needed to lose weight, I wouldn't count calories - I would just cut out sugar and eat a largely vegetarian diet with lots of pulses. That was sufficient to lose weight, although I'd still have to be careful not to undereat. Believe me, 3 days of migraines and I think, who needs this, I'd rather be fat.

    But, the no-sugar, more lentil diet doesn't cut it anymore. Stoopid slower old metabolism. The goal here is not primarily weight loss - although that would be nice. The goal is to discover, is there an ideal calorie level, and an ideal macro nutrient combo, that will prevent migraines, and allow me to lose weight slowly? What is the caloric level, or carb level, under which I must not go? Malted Tea, you mentioned the brownie/advil approach and when I feel that edge of a migraine coming on, I have used that too - although I use Naproxen instead of advil, washed down with coffee. Sometimes that works.

    Most people who get migraines have a variety of triggers, but I've only had two - hormones, and not eating. With menopause the hormonal issue went away, but I'm disappointed the other issue did not.
  • cmriverside
    cmriverside Posts: 33,992 Member
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    You mention caffeine...are you using a lot of caffeine? I have to be on a pretty strict schedule or I get headaches. Not migraines, though. Migraines are not affected by OTC meds nor caffeine.

    Have you had your migraines diagnosed? Are you sure there aren't two different types of headaches happening? Caffeine, sugar and wheat are common culprits for headaches in general, but migraines...totally different thing.
  • Mithridites
    Mithridites Posts: 595 Member
    edited November 2020
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    Perhaps tracking accurately and maintaining a small deficit combined with stable macros and caffeine intake would allow you to find a way to lose pounds slowly but comfortably. How big was the deficit that triggered the migraines?
  • EmpressBarbara
    EmpressBarbara Posts: 18 Member
    edited November 2020
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    Mithrides - well, that's the question I'm trying to answer by using the food/calorie tool here - is there a minimum number of calories I always need to consume? Or does the macronutrient ratio play into it? What about stress - under very stressful conditions, I can eat very little and get away with it. At this point, I have no idea if it's the same amount of calories every day.

    cmriverside, what I have are migraines, and my doc agrees - they come with vomiting, light sensitivity, pressure, sensitivity to sound, wanting to blow my brains out with a shotgun just to stop the pain (not really but close) - the usual. I have one coffee in the morning, and sometimes another or tea early afternoon. I don't get non-migraine headaches often, hardly ever in fact.

    There is unfortunately no simple answer to my problem - before menopause, I could more or less keep the migraines, and the weight, under control with intuitive eating. Having to constantly count calories every day is cumbersome and difficult, and I'm not even sure it's the answer. But I'm willing to try because nothing else is working, and I don't want the weight to keep creeping on.

    What I mostly wanted to know is, is there anyone else out there like me? I scan google and the medical literature at my university library occasionally but while calorie deficit often results in headaches, I haven't found that it is linked to migraine. Surely I can't be the only one?
  • ladyzherra
    ladyzherra Posts: 438 Member
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    Migraines are tough to figure out. When I have one, I also tend to crave simple carbs afterwards. Figuring out the trigger is helpful, and then avoiding it when you can.
  • cmriverside
    cmriverside Posts: 33,992 Member
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    Mithrides - well, that's the question I'm trying to answer by using the food/calorie tool here - is there a minimum number of calories I always need to consume? Or does the macronutrient ratio play into it? What about stress - under very stressful conditions, I can eat very little and get away with it. At this point, I have no idea if it's the same amount of calories every day.

    cmriverside, what I have are migraines, and my doc agrees - they come with vomiting, light sensitivity, pressure, sensitivity to sound, wanting to blow my brains out with a shotgun just to stop the pain (not really but close) - the usual. I have one coffee in the morning, and sometimes another or tea early afternoon. I don't get non-migraine headaches often, hardly ever in fact.

    There is unfortunately no simple answer to my problem - before menopause, I could more or less keep the migraines, and the weight, under control with intuitive eating. Having to constantly count calories every day is cumbersome and difficult, and I'm not even sure it's the answer. But I'm willing to try because nothing else is working, and I don't want the weight to keep creeping on.

    What I mostly wanted to know is, is there anyone else out there like me? I scan google and the medical literature at my university library occasionally but while calorie deficit often results in headaches, I haven't found that it is linked to migraine. Surely I can't be the only one?

    What about if you use a more or less "grazing" plan?

    Blood sugar fluctuations can trigger headaches for me. I never tried dieting or eating in a deficit when I was getting migraines. I was seriously just in Survival Mode, though. I can totally relate to your shotgun statement. There was many a time I just wished I would die to escape that kind of ongoing relentless misery.

    Many hugs.
  • EmpressBarbara
    EmpressBarbara Posts: 18 Member
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    I graze like a boss - if that's an expression. I try not to let myself get overly hungry, because of the migraine trigger.

    Yes only fellow migrainers can understand. I used to work in a hospital and sometimes noticed the nurses getting judgmental when people with old head injuries would come in looking for drugs. Sometimes these people were grey with pain. Because of my experience with migraines, I never judged them for their drug seeking/medical help seeking behavior - I could understand what drove them. I sometimes thought that the medical personnel who were dismissive had only experienced, at worst, a bad headache, and were comparing their patient's pain to that. If they experienced a bad migraine, even once, maybe they'd have more empathy.
  • heybales
    heybales Posts: 18,842 Member
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    For years my main trigger was during a period of lack of regular exercise, combined with life (usually summer for later sunsets) that had me busy working until late with no supper, so then late dinner, usually with being up later - the next day afternoon would usually start getting a migraine.
    So I figured something with glucose levels and lack of sleep.
    Blood tests always showed fasting levels just fine, I had overreaction of insulin and low level drops actually.

    If caught early 50 mg Imitrex was enough to knock it out after 1-2 hrs
    If I happened to wake up with one going or taking meds late, needed 100 for 2-4 hrs knock out.

    So I figured 3 times weekly getting knocked out for 6 hrs minimum meant try to get that much exercise in at least.
    I found at least 4 hrs weekly, and the late triggers were no longer a trigger.
    I had no other triggers on their own, perhaps combined, but not while exercising enough.

    One time after reading a study was skeptical about IF method of eating in my case, since I was sure I needed breakfast and lunch with decent protein & fat to make it through day and a good workout. Totally unrelated to migrains.
    Tried it and shocked even with huge evening workouts prior to eating had no issues. It appears I store a lot of glycogen in liver, or I slip into ketosis daily easily (never tested).

    Anyway, after some busy life and injuries and no exercise - discovered no migraines with the trigger of eating late and up late. Even adding chocolate which was sometimes a stacked trigger (not on it's own).

    So I fully believe in my case the migraines were a result of glucose levels, from normal reactions I'd guess low since I still have a strong response to low blood sugar after eating due to insulin over-response it seems.

    My levels of migraines were never as bad as many, I know that. Without meds they would be gone in 4-6 hrs anyway. And while every sense was heightened to discomfort or pain level and felt like puking unable to do anything, it wasn't as bad as others.

    Just to say with all that - blood test for fasting, but also the glucose tolerance test to see reactions.

    Or if you like experimenting with things, try IF for a few days.
    Warning - it does go against most advice on the matter to not fast. Only a bit of research shows benefit.
    IF does show benefit though to improving insulin response in pre-diabetic and diabetes.

    Amount of deficit may be the side effect of eating less of some macro - so good idea to find maintenance, or just log what you eat anyway to get an idea before changing things.
  • EmpressBarbara
    EmpressBarbara Posts: 18 Member
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    I did try the IF, got a massive migraine - but that might have been in combination with not enough food. I think I'll figure out first what my minimum caloric requirements are before trying anything else.
  • tayusuki
    tayusuki Posts: 194 Member
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    Not sure what you're eating, but migraines -> carb cravings sound like it could be an electrolyte imbalance? Especially if you're cutting lots of refined carbs. Another thing to consider. ^^
  • EmpressBarbara
    EmpressBarbara Posts: 18 Member
    edited November 2020
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    I doubt I have any issue with electrolytes. In a healthy person like me, you only see electrolyte imbalance as a result of excessive vomiting, sweating, fever. Nor do I eat a lot of refined carbs, ever. I'm a whole grain girl. Except, of course, after a migraine!
  • EmpressBarbara
    EmpressBarbara Posts: 18 Member
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    As an update - 7 days of recording calories, it seems that I can keep the migraines away at around 1900-2100 calories. Or I have this week anyway. Below that and I can start to feel it coming on. I was a bit surprised that I eat a relatively high ratio of fat to protein - healthy fat, for the most part, but still, I thought they'd be at least equal. Or hoped they'd be. Today I loaded up on lean protein but then did 40 minutes of shoveling wet snow - and by 3 PM, boy was I crashing, energy-wise. My body really hates to go to its glycogen stores for energy. Maybe that's where the migraines come from. Glycogen hoarding syndrome. That's a new thing I just made up but maybe one day we'll find out it's real. ; ) (Not to be confused with Glycogen Storage Disease which is a real thing, but not what I have thank heavens).

    So, having gathered that evidence, now we'll see if I can lose any weight staying in the 1900-2100 calorie zone. I'll let you know in about two weeks.
  • yirara
    yirara Posts: 9,420 Member
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    I doubt I have any issue with electrolytes. In a healthy person like me, you only see electrolyte imbalance as a result of excessive vomiting, sweating, fever. Nor do I eat a lot of refined carbs, ever. I'm a whole grain girl. Except, of course, after a migraine!

    This comment has been downvoted a lot without explanation. Yes, you lose electrolytes if you eat less carbs than previously. People who start keto call it ketoflu, and it does cause headaches. It's related to glycogen depletion. Every person that eats a normal to low sodium diet also has a natural glycogen cycle of roughly 4 weeks in which glycogen gets reduced and refilled again. There are some indications that people on a high sodium diet don't have this, but last time I checked (don't have full access to scientific papers anymore) there was no proper explanation for that.
  • cmriverside
    cmriverside Posts: 33,992 Member
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    I agree that keto flu (or low carb in sensitive people) does cause headaches due to electrolyte imbalance. I don't know about migraines, I always felt like mine were hormonal, or tied to certain food or weather/barometric pressure. Knowing what I know about migraines for 30 years and food - I would not try to lower carbs without increasing salt by a lot. I do think (for me) there is a link between migraines and wheat. I proved that over and over. When I cut wheat I had fewer migraines. I still ate a lot of carbs, though.

    1900-2100... I also think that one week on this doesn't necessarily mean it's the magic number. It just means that a lot of other stars aligned for you and 1900-2100 happened to be the amount you ate.