Dehydration and Salt Deficiency Trigger Migraines

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Angela A Stanton,Ph.D.
I had migraines for well over 20 years. I am not alone; about 12% of the US population has migraines. Initially, I thought I had headaches but my “headaches” were accompanied by symptoms that are not normally part of headaches: anxiety, IBS, RLS, nausea, sensitivity to darkness, light, smells, and everything seemed irritating. I learned later that these symptoms are part of prodome; a sort of early warning that a migraine is coming.

I have a PhD in NeuroEconomics. My work had less to do with the economics side of this degree and more to do with the neuroscience. As I was working through my PhD, I had migraines, but with the demands of school, two kids and a husband, I neither had the time nor the understanding to attempt a scientific study for finding the cause of migraines. I did what everyone else with migraines does: I took pain killers. When the pain killers didn’t work, I took triptans (serotonin medications). When those medications didn’t work, I went to the emergency room (ER) to get an IV with electrolytes and injections of heavy narcotic medications.

Eventually, nothing worked and I had to find something to help with my migraines. I applied the knowledge I gained from my education to find a cause for my migraines. What I learned was that the cause was right in front of me all along. Migraines could be triggered by dehydration and sodium or salt deficits. Although this is not a theory that has been tested yet, consider the first treatment a migraineur receives in the ER – IV fluids with electrolytes. This is an important clue that in hindsight should have tipped me off. Let me explain.

Neuron Activity and Migraines

In order to understand the connection of electrolytes to migraines, looking at an individual brain cell (neuron) is critical. The image and the function of cells is in every biology 101 book. I realized though, that the basic necessity of the neuron’s survival itself had not been examined by scientists in the context of migraines. Most migraine research begins with the pain of migraine. Scientists often consider that pain to be the cause, so they look for pain relief as their solution. But pain is a symptom rather than the cause. In fact, migraine itself is a symptom of something out of balance in the brain. The real cause is a biochemical imbalance in and around the neurons. Amazingly, ER nurses who use IV electrolyte treatments for migraine have been trained to do the right thing without realizing the importance of what they were doing. Why exactly do nurses start migraine treatment with electrolytes? I asked one nurse and she said: “you are dehydrated.” Interesting, I thought, since I drink plenty of water. How can I be dehydrated?

What is Hydration?

Being hydrated and drinking water are only partially connected. “Hydrate, a term used to indicate that a substance contains water” implies that water is only part of hydration. Electrolytes that I received for my migraines were not just water but brine containing many essential micro nutrients, minerals, and, most importantly, salt. If you look at a cell, it has a membrane that separates it from the external environment with bumps and pores on it. Anything that wants to go into the cell or come out of it must do so on the demand of the cell or by osmosis via channels. This indicates that drinking only water can dehydrate since it can enter the cells via osmotic channels through the membrane but larger elements cannot. However, there are many elements inside the cell, such as sodium (Na+) and potassium (K+) among other things. Via osmosis, K+ may leave the cell if the K+ concentration outside of the cells is smaller than on the inside, thereby dehydrating the cells but NA+ is too large to leave or to enter. This can lead to a very dangerous health condition called water toxicity in which all nutrients leak through the osmotic gradient leaving too much water behind.

Salt Deficiency, Hydration and the Neuron

NaCl (salt) breaks up into ions and separate based on polarity in the body. Na+ (sodium) is inside the cells and its job is to attract and hold onto water, thereby hydrate. The job of Cl- is to maintain optimal hydration fluid levels outside of the cell. Note that Na is positively charged (+) and Cl is negatively charged (–) and these polarity differences result in voltage differences. Cells without proper quantity of Na+ and Cl- are not capable of voltage generation of the right magnitude. One of the functions of this specific voltage magnitude is the enabling of the sodium-potassium pumps that are located on the membrane of the neuron. Without proper voltage for the pumps, they may not be able to open to the outside or to the inside of the neuron.  When a cell cannot open to the outside or to the inside, no exchange of nutrition can take place. Cells without sodium cannot retain water and remain dehydrated. Could malfunctioning pumps, brought on by low salt concentrations, be one of the triggers of migraine?

Sodium Potassium Pump

Low Salt Initiates a Cascade of Problems

We have several other issues without the proper electrolyte fluids inside the cells. Electrolytes carry magnesium, for example. Magnesium is used by the cells like a key to open the pumps. If there is no magnesium inside the cells, even if there is plenty of water and salt, the pumps cannot open. Phosphates provide the energy for the magnesium to open the pumps and so phosphates are also needed inside the cell. There are high voltage calcium channels in neuron membranes as well. Without high voltage, the calcium channels cannot work. Thus, even if there is enough voltage to hydrate the neuron and to create neurotransmitters, they are stuck without functioning high voltage calcium channels. Lack of calcium is not a serious problem since our bones are calcium storage sites from which calcium can always be drawn. Of course, osteoporosis is the outcome of low calcium availability to the cells. The brain also often swells in response to neural biochemical imbalance. The swelling itself has a variety of explanations, but not yet a coherent scientifically proven reason.

Migraines and Dehydration Triggers

Let me connect dehydration, lack of voltage, lack of sodium-potassium pump functioning, osmotic leakage, calcium channels, and migraines all together into one picture so you can see the connection.

Neurons without electrolytes in their environment cannot function. They are idle, dying, or dead—this is defined by new research just published in the Journal of Neuroscience as “brain depression”. Neurons are connected to communicate with each other. When neurons in a region don’t function, neighboring neurons try to awaken them—this is referred to as the spreading of electricity in the parts of the brain that are not in depression in the same scientific article. This is seen as aura in those with migraines in the occipital lobe of the brain. For migraines in other regions, the healthy neurons signal pain sensing nerves located in the meninges, a tissue separating the brain from the skull (there is no pain sensing nerve inside the brain). Migraine is pain signaled by pain-sensor neurons in the meninges and so the location of where we feel pain is not necessarily connected to the location that causes pain. If migraines occur seldom, they are not concern for alarm. If migraines are frequent, over 15 a month for several months, they are considered to be chronic. Chronic migraines may change the shape and function of the brain as well as make it more prone to strokes.

Salt Deficient Migraines

Currently, there are no published studies linking low salt to migraine onset and to my knowledge, there are no studies underway to investigate the effect of salt deficient diets on migraine. The evidence I have supporting this hypothesis first evolved by connecting the common clinical practice of IV electrolytes for migraineurs to the physiology of sodium-potassium pumps on the neurons. Next, I tested it on myself. It worked. Subsequently, others who have applied electrolyte hydration protocol have found that they can prevent or treat their migraines without medicines. After 20 years of migraines, I have been migraine free for four years now as a result of proper and regulated hydration, assisted by apps on my smart phone.

There is nothing like migraine free and medicine free life. While this may not be the only cause of migraines, it is physiologically likely that salt deficiency and dehydration can initiate a migraine. Together, with the theory and applied evidence by the many who use the hydration protocol, it is my belief that salt deficiency and dehydration ought to be considered as a possible cause and the hydration protocol be applied as the first line of treatment for migraine pain instead of medicines. Clinical trials with salt and hydration versus placebo may be an option albeit giving placebo to a person with migraine may not pass ethical committees’ scrutiny for experimenting.

About the author. Dr. Stanton received her BSc at UCLA in mathematics, MBA at UCR, MS in Management Science and Engineering at Stanford, PhD in NeuroEconomics at Claremont Graduate University, and fMRI certification at Harvard University. Follow her on Twitter at: @MigraineBook.

Additional References

  1. Altered Hypothalamic Functional Connectivity with Autonomic Circuits and the Locus Coeruleus in Migraine, Eric A. Moulton et al. PLOSOne; April 17, 2014
  2. MRI shows brain abnormalities in migraine patients, March 26, 2013, Radiological Society of North America
  3. The Cerebellum and Migraine, Maurice Vincent, MD, PhD and Nouchine Hadjikhani, MD,
  4. Headache. Jun 2007; 47(6): 820-833.doi:  10.1111/j.1526-4610.2006.00715.x
  5. Parenchymal spin-lock fMRI signals associated with cortical spreading depression
  6. Joonas A Autio et al., Journal of Cerebral Blood Flow & Metabolism 34, 768-775 (May 2014) | doi:10.1038/jcbfm.2014.16
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75 Comments

  1. This makes sense. I have had migraines since 4-5 years and i recently took up (without salt) fasting one day per week and everytime i get migraine by the end of the day. I have low blood pressure normally and sugar doesnt suit me since Childhood, when i had no migraines. I knew going without salt wouldn’t suit me but trying it gave me more clarity on the salt my body needs. I drink water quite a lot still dehydrated. And triptans never work for me. I have cravings for salty food and against sugar. But also my body is positively affected by foods rich in b vitamins and i have b12 deficiency too.

    1. Hi Prachi,

      Indeed, salt is essential. So please start eating salt, avoid sugar and reduce carbs, increase fats to allow your brain to heal. Most migraineurs have MTHFR C667T variance and that is associated with methylation issues. It would be great to test for your methylation (homocysteine) and all B vitamin level. If you are off, you need special non-synthetic B vitamins–so not 1 pill but each B separately. Avoid niacin (B3) as that causes diabetes.

      Good luck!
      Angela

  2. Few more things need to mention. I get a kind vibration inside my body, it happens some times, but for years a back I got a kind fire inside my body, which was very horrible I never experienced that in my entire life.
    Now I get very cold feet too. I am a kind of type I use to sweat a lot. please help me out. Thanks in advance.

  3. Angela, it’s a little over a year later and I am back on your Webpage. I’ve been experimenting with NaCl pills, coconut water (for potassium), Pedialyte, and simple salt water (1/4 tsp per 20 oz. of water) with some but limited success. A recent colonoscopy prep taught me something else important about my migraines and you have mentioned it on your Webpage but I just wasn’t receptive for it a year ago. The day before the colonoscopy, I did homemade bone broths in the morning and then I took the miralax in homemade lemonade. It had some sugar in it but much less than the recommended Gatorade. By the evening, I started feeling a migraine and I wasn’t allowed to eat and drink anything after 9 pm, so by the morning, the migraine was pretty bad. After the colonoscopy, I consumed the offered grape juice and muffin and the migraine got worse. A few days later it hit me. The lemonade caused a spike then drop in blood glucose and the level probably got very low over night. Then, I repeated the spike and drop with the grape juice and muffin. Now I am avoiding high glycemic load foods and have had more success than with the electrolyte experiments. I still seem to be more prone to migraines during times of low estrogen, so I am wondering if there is a connection to female reproductive hormones and how we handle blood glucose fluctuations. Also, from what I read on your Website, you seem to think that the electrolyte drops are the primary reason for the migraine and the blood glucose fluctuations cause migraines by affecting electrolyte uptake. I don’t quite understand the connection yet. Now when I get a migraine, I usually eat easy to digest foods that release glucose slowly, like carrots, and drink plenty of water. Is that the right thing to do to get back in balance? (I still haven’t figured out if it is a sudden drop in blood glucose or simply a drop below a certain minimum that triggers my migraines.)

    1. Maren,

      I am glad you returned because your discovery actually leads to a different conclusion from what you think. Electrolyte is the primary concern but since you are not in my migraine group you are not familiar with the details of why electrolyte balance goes out of homeostasis and why that is a problem.

      Migraineurs have several gene mutations and many within the mutated group are associated with glucose metabolism. In short: migraineurs are glucose intolerant to the point that every time you eat or drink anything sweet (need not be added sugar, just take a bite of apple) and within a short time that amount of glucose removes sodium from the cells as well as water, makes migraineurs thirsty as well. This can cause a lot more problems than you think. In addition to migraine, this (and you glucose variation level) suggest a metabolic syndrome connection, which is a genetic mutation for us migraineurs. There is much literature on migraineurs and that they seem to be connected to metabolic syndrome but the research always ends with “further research is needed to understand the connection.”

      Well I understood the connection when I wrote the 1st edition of the book (here in e-book and here in paperback) but now in the 2nd edition (still working on it) the emphasis in any form of glucose will be much greater.

      To be migraine free you need to completely stop all sugar types (including honey or anything else), all sugar substitutes (including Stevia and the rest), and also reduce your carbohydrate intake significantly. For example, migraineurs who can prevent their migraines really are on the low carbs high fat (LCHF) diet or at least on the Banting or similar. Those who actually venture into the ketogenic do the best because one of the other genetic mutation is around the myelination of the axons (in English: insulating the part of the brain cell that carries voltage). Fat metabolism is (as a result of glucose metabolism) is also mutated and so the only way to reset the brain to use fat the right way by the brain is by the ketogenic diet.

      You also mentioned coconut drinks: coconut drinks–unless you live chop the top of a fresh coconut off the tree and drink that–have potassium supplements in them. Potassium in supplement “hits the heart” so to speak–that is why they are prescribed to hypertensive patients! I call potassium supplements “in-cell diuretics” though they are not meant to be diuretic, they cause “resting potential” that relaxes the membrane of the cells and as potassium enters the cells, sodium and water leaves. So taking potassium supplements (and sport drinks have the supplemental form in them) actually prevents action potential (the voltage type that would open the pump gates to retain hydrating fluids) and, instead, send all nutrients out of the cells by generating a resting potential. People with low blood pressure (and migraineurs usually have lower than even a low blood pressure) may faint from potassium supplements at best. At worst can end up with a seizure. I don’t recommend you drink potassium drink.

      What I recommend: eat potassium heavy food that is low in carbohydrates (think avocado, zucchini, cauliflower, broccoli, spinach, salmon, steak) and salt in proper ratio–available in my migraine group. Don’t drink any sport drink. For quick hydration, grab a glass of whole fat organic milk.

      Hope this helps!

      Angela

      1. Thanks so much, Angela. It all makes sense. The coconut water did not help and gave me a scare once, because I drank too much in one day and got irregular heart beat from it. Fortunately, my kidneys seem to work fine so the next morning, everything was back to normal but I saw some scary articles on what potassium overdose can do to your heart.

        It also occurred to me that the glucose connection could be the reason why I sometimes get migraines after a workout even if I hydrate excessively. Maybe it happens when I eat something before the exercise that brings my insulin level up so that glucose drops to very low levels during the exercise. Now I try to eat something like carrots 1-2 h before a workout and hope that it releases glucose slowly to keep my level from dropping too low.

        I have not noticed any problems from apples or any fruit. I stopped eating bread, pastries, bagels, pasta, and most other grain products and dried fruit (raisins, dates, prunes, etc.). I stopped using honey (in yogurt) or maple syrup on pancakes (4 parts egg, 1 part gluten free pancake mix). I eat egg, bacon and fruit smoothy with avocado for breakfast; soaked almonds, raw carrots, and apple throughout the day; and some meat or fish with veggies and butter for dinner. I love how this diet freed me from my sugar cravings in the early afternoon and the urgent need to end hunger in general. I feel like I am no longer a slave of the restaurant and food services industry. It is so liberating! (And the weight loss is an added bonus. I am losing about a pound a month and am currently in the upper third of the normal range.)

        I still need to tweak my diet a bit to see what works and what doesn’t. For example, I am not sure about legumes. I recently incorporated them again as a source of fiber and mix them into my veggies for dinner but they have a bit higher glycemic load than most vegetables.

        I was ketogenic once after an illness and loved the feeling. I found out because I was monitoring something in my urine and the dip stick had a field for ketones. I’m not sure if I could lower my dietary glucose that much, though.

        1. Angela, I realized that I have two more questions:
          1. Can/should I get tested for certain genetic mutations?
          2. What do you think about zolmitriptan? It was the drug that helped me before I had my daughter but I haven’t been able to take it until she weaned herself a few weeks ago. My goal is to avoid migraines through my diet but if I do get one, could I take the medication or do you have strong concerns about it?
          Thanks, Maren. (I sent a Join request to your Facebook group.)

        2. Hi Maren,

          In terms of glucose: migraineurs have a gene mutation with how they metabolize glucose. Although eating carrots or other even more fibrous carbs full of glucose, at the end it is still glucose! So the outcome is still going to be the same. In general carbs can only provide little energy for workout. I recommend you consider an alternative diet, such as the low carbs high fat (LCHF) diet, in which the amount of carbs is taken to very low levels and fat increased to very high level. The goal would be to switch your metabolic process from carbs burning to fat burning at a low nutritional level. This is called nutritional ketosis. There is quite a bit of information about it by now all over the place since it is more and more clear that the obesity and metabolic disease epidemic was caused by carbohydrates and low fat diets. I have a keto mild for migraines group that you are welcome to join to learn how to do it.

          As a fellow migraineurs, and since I have been where you are now, I recommend you consider your genetic makeup and eat for your health rather than what you believe is healthy.

          Someone commented on my FB wall just yesterday asking if I know that vegetables and fruits are good for me and I responded “they are actually bad for me.” Few people realize that. About 30% of the population can tolerate carbs without any problems but migraineurs are not in that 30%! So while you may not feel that eating an apple harms you, it can harm you and give a delayed reaction depending on how sensitive your insulin is–you may come down with a migraine 2 days after that apple and will not remember what caused it. Most migraineurs have compromised insulin sensitivity from triptans as well, which cause type 2 diabetes.

          You can test for genetic mutations if you wish but it is not necessary. There are many genes that are mutated in a migraine brain and we already know what they are, so no need to spend your money to get confirmation that “yep, you are a migraineur”.

          Zolmitriptan is a triptan. I am very much against any medicines and people who read my book, many of whom join my migraine group, are migraine free after a few months and come off medicines. There are group members who had surgically implanted neuronal stimulators removed… no more need for them. I personally have not taken any migraine medicines since 2010.

          So rather than getting yet another serotonin medicine that has nothing to do with the cause of migraines, I recommend you focus on the cause and apply prevention.

          Best wishes,
          Angela

          1. Dear Angela,

            Could it be that it is not “one migraine gene” but possibly a combination of genetic mutations that cause migraines. All my relatives have a weight problem but none of them have migraines (except my great grandmother, from whom I was told to have inherited it).

            Is this mutation affecting the insulin receptor or the glucose transporter?

            Last night, I checked for ketones and was surprised and happy to see a “moderate” (40) level of ketones. I will continue to eliminate high carb food from my diet. Bananas and beans are next.

            Mostly, I am concerned about my daughter. How can I determine whether her metabolism handles glucose well or not?

            Thanks,

            Maren

            1. Dear Maren,

              I am sure that there are more phenotypes for migraine but likely only one gene (MTHFR), which has many alleles. I am not a geneticist so I cannot say too much detail but I have been genetically tested and the first result coming back on my test said “Angela you are likely an aura migraineur” because of the particular 667ct phenotype that is associated with that. But the MTHFR gene is associated with many things, including vitamin B absorption ability (or lack thereof, as in my case) and several other things. I should add that to my knowledge no one in my family had migraines (spontaneous mutations are always possible); however, on an old photo of my grandmother I received from a cousin, I could see that she was a migraineur. Migraineurs have one eye become smaller as a prodrome starts. Genes can skip generations as you can see in my case, particularly if the inheritance is heterozygous (meaning only one copy from a parent).

              To be a migraineur is to be glucose sensitive (another genetic mutation) and this brings about a bigger reaction to glucose than for other people–migraineurs have several other mutations, such as voltage gated sodium/potassium pumps and also glucose transporter mutations. This makes migraineurs more likely to end up with metabolic disorders and that includes type 2 diabetes, obesity, and alike. Weight problem on its own is not a representative of migraines–many migraineurs are very thin.

              In terms of your daughter: she may not yet have the migraine-brain and even if it will develop at a later time or even if it may never develop, avoiding glucose is important for her health, in general. It is now fully understood that glucose causes metabolic syndrome so why take a chance? Let’s teach her healthy eating from the start! There is nothing wrong with an occasional sweet but certainly not every day or not even every week. There is really no room in a child’s diet for refined carbohydrates like pasta and rice or cookies and candies. It is not easy to implement but important!

              It is also important to provide your daughter with plenty of whole foods that are rich in natural vitamins, mineralsm and fats–be it animal or produce. Lots of eggs as well for the many nutrition types they have plus she (we all) also needs cholesterol (lots of cholesterol in the brain and the brain is over 60% fat so lots of animal fats as well–butter is great for that). So feed for her brain and not for her taste buds!

              In terms of ketones: I found the urine strips extremely inaccurate. They show high ketone levels when your body is actually reducing ketones (it is ketone dumping) because the glucose backes up for some reason. The reason could be medicine that occupies insulin receptors, such as Prednisone, could be hormonal such as estrogen, or having not eaten for some time and the liver dumps glycogen, which is glucose, in addition to having eaten some food that was too high in carbohydrates. In my keto mild group, which you are welcome to join, I request everyone to measure blood ketones (beta hydroxybutyrate). Nothing else so far designed is capable to measure your ketosis level accurately.

              Hope this helps,
              Angela

    2. I have been in very painful situation. I am completely dehydrated, low libido, bloated, constant tired, gaining weight, decreased appetite, low metabolism, nose bleeding, heart beating, noise disturbing me esp. my left ear, I cant run, workout properly, got thinning hair. It happened to once before for 4 years back, at that time i quieted workout etc. and at the same time I started to eat all kind of foods where gained weight and fortunately I got fine. What I found out was I suddenly could drink liters of water without it goes through my body. Now I am almost in same situation. I dont to how much should increase my salt intake and potassium, even i have tried all?

      You mentioned if your urine is colorless, then you need potassium? I normally eat a banana after my workout and i do eat dates?

      1. Hi Maren,

        Not sure where I wrote that you need potassium when the urine is colorless. In fact, eating a banana is equal to between 6-12 teaspoons of glucose, depending on the size and very little potassium for all that glucose in exchange–not worth it. Plus, potassium causes resting potential (not action potential), meaning it removes sodium and water from your body–that dehydrates rather than hydrates. Eating potassium foods after workout is a problem since they don’t hydrate. I have spent years trying to explain this to people who drink coconut water during or after their workout: it is harmful. Instead, take some salt or a salt pill with a whole glass of water after exercise. One doesn’t perspire potassium but salt and water.

        Your symptoms as you describe could be caused by MANY reasons: thyroid problem, adrenal problem, mineral toxicity, or lack of enough minerals. I now recommend everyone to test how they can absorb vitamins and minerals from their food or supplements. A simple blood test can tell you if you have too much or enough. If you are low in some minerals in spite of supplementing it, I recommend genetic testing because migraineurs, for example, often have mutations that prevent them from absorbing B vitamins. Some of the symptoms you describe may come from your body’s inability to absorb B vitamins–in particular B12. Please have a doctor visit so they can test all variables for any disease that may have the symptoms you present and also ask to have them check B2, B6, B9, and B12, D3, A, selenium, magnesium, thyroid test TSH, free T3 and T4.

        In terms of potassium to salt ratio, eat a potassium heavy diet and salt heavily. The fact that you ate all kinds of food and you returned to health means you lack some minerals and are out of electrolyte homeostasis. You need to pay attention to what you eat. Carbohydrates dehydrate as mentioned above and are also unhealthy. Refined carbohydrates should completely be stopped since they are fattening (fat deposit is caused by sugar and not fat). I reduce carbohydrates like veggies, fruits, nuts, and seeds to the bare minimum in my diet; I eat no grain of any kind (not even gluten free). I personally favor the ketogenic diet or at least the low carbs high fat (LCHF) diet. I stopped sugar and all sweeteners 2 years ago and grains over a year and a half ago–I NEVER looked back.

        You need to use a water calculator to see how much water you need since too much water can wash your body void of electrolytes and that can lead to water toxicity. Water toxicity can be fatal. Cold feet represents circulatory problems. I also have the vibration in my body. My doctor said it is “hyper sensitivity” but I think it is connected to a circulatory problem as well. When I have the time to exercise, the vibration subsides and I can have days without it. It is an ongoing battle though. It is possibly a hyper sensitivity of the nerves that manifests itself like all your nerves were moving but since it quiets down after a workout, I suggest it is mixed with circulation issues.

        Hope this is helpful!

        Angela

  4. That was a very interesting read! Can you please explain more about supplement potassium not a good idea, I had my migraines under control but I added potassium gluconate and Ive had a return of migraines.

    1. Hi Penny,

      There are several issues with supplementing potassium via pills as opposed to eating it bonded in food. So first let me bring up 2 critical points to demonstrate who needs potassium supplementation and who does not:

      1) Migraineurs are usually hypotensive (when not in pain), meaning their blood pressure is low;
      2) Hypertensive individuals (people with high blood pressure) are usually prescribed potassium.

      So from these two points you can already see that potassium supplementing for migraineurs will be a bad idea since they have low blood pressure to start with and that potassium must do something to help lower blood pressure. Indeed, I call supplemented potassium “in cell diuretic,” meaning its job is to release water from the cells, which reduces blood volume and that then reduces blood pressure. It does so by relaxing the heart’s smooth muscle and thereby initiating a “resting potential.”

      The way it does it causes a big problem for migraineurs. If you read the Anatomy of Migraine article you can see that the cause of migraine is what is called cortical depression (CD). This represents a brain region that has no proper energy to generate action potential. A healthy cell goes through 2 stages: action potential (sodium enters the cells and holds onto water) and then it switches over to resting potential, during which potassium enters the cells and sodium leaves, taking water with it.

      With potassium in the cell and sodium out of the cell, nothing holds water in the cell. While potassium is not a direct diuretic, it acts like one, hence it is beneficial for high blood pressure to reduce it.

      This article you commented on is about how important hydration is to prevent migraine so when your cells get dehydrated, a migraine is eminent. Now why does this happen when you take potassium in supplement and not when you eat an avocado full of potassium?

      When you take a supplement, all potassium in that “hits the heart” so to speak. This is one reason why you cannot buy potassium supplements over the counter that are larger than 400 mg potassium. If you have low blood pressure and take a potassium supplement, you can even faint. It can reduce your blood volume, which for migraineurs is already low, and thereby may lower your blood pressure that is already low.

      When you eat an avocado (900 mg potassium for a Florida avocado and 600 for a Hass avocado on average), the potassium in it is bonded to a variety of other minerals, fatty acids, etc. It takes time to break it down and it moves through your metabolic pathway as food. As such, it helps create electrolyte just like any other food would, and gets to where it is needed little at the time and with your body’s metabolic process in full control. A supplement just enters at once without metabolic processes. This can cause a major problem.

      In a Petri dish, researchers showed that a single potassium ion is capable to create a seizure (Wei Y, Ullah G, & Schiff SJ (2014) Unification of Neuronal Spikes, Seizures, and Spreading Depression. The Journal of Neuroscience:11733-11743). One of the most significant differences between seizures and migraines is the speed and direction with which the voltage travels in the brain. During a seizure, voltage travels fast and randomly whereas in a migraine, the cortical spreading depression (also referred to in the Anatomy of Migraine article) is slow and its direction is specific to awaken those cells in CD that are without energy.

      Many migraineurs end up with seizures simply from eating too much potassium in their food without the proper balance of sodium! Taking potassium supplements can get you closer to a seizure episode, particularly if your electrolyte was in need of sodium instead of potassium.

      Hope this helps.

      Best wishes,
      Angela

  5. Hi Angela,
    I get migraines monthly, right around the onset of my monthly visitor. I’ve never been very regular, so sometimes it is difficult to know when to expect both of these little ‘blessings’. I typically don’t take medications for migraines, as I prefer more natural methods, and nothing really seems to help, anyway. Many RX meds have side effects that are almost as terrible as migraine pain. So I suffer / (try to) sleep through as much of the migraine as possible. When they last anywhere from 1-3 days, that can be pretty disruptive to everyday life!
    Some Drs. have suggested certain vitamin supplements to try to counteract the migraines (one being magnesium), and I try to load up on all kinds of magnesium rich foods when some of my migraines symptoms (most common is extremely acute and sensitive smell) appear.
    Now, I’ve also always had issues regulating my blood-sugar levels. Nothing that’s ever been diagnosed (it’s always normal when I take a fasting-blood glucose test…go figure!), I just feel my levels crash (again, more commonly near my monthly), and then have to work fast to get them back to normal. …Basically, all of this eventually led me to trying to balance my electrolytes. This is the first month I’ve tried it, and while I can feel a kind of tension in my head and neck, and fatigue behind my eyes, my migraine has been kept at bay. It’s there, it wants to come crippling in, but it’s not progressing. I’ve taken a couple of ibuprofen over the course of a couple of days, and it’s actually helped!
    Your article was the first I’ve come across to validate this ‘hunch’ at balancing electrolytes, and to hear you’ve been migraine free makes me so happy for you, and so hopeful for me! Thank You Thank You! & Best Wishes!
    Abby

    1. Hi Abby,

      Thanks for your message. Glad you had a hunch; indeed, migraine responds to keeping electrolyte in balance except that migraineurs’ electrolyte needs to be higher in some of its minerals than regular people’s electrolytes. If you read the Anatomy of a Migraine article I wrote a couple of years ago you will read that migraineurs have a different brain anatomy. A migraine brain is filled with hyper sensory organ neurons that have more receptor connections than sensory neurons in a standard brain. That means the migraine brain uses more energy. The kind of energy it uses more of is not glucose (contrary to popular belief the brain does just fine with without a drop of glucose!) but salt, potassium and magnesium. Do not take potassium in supplements since it does something else–it needs to come from food.

      Migraine brain cells use more voltage and these are the three most critical elements of cellular voltage generation. Migraine is the consequence of a brain region running out of voltage and thus “goes offline” so to speak. The rest of the regions that are connected to it want to shock (literally, a voltage shock called “cortical spreading depression” which is a wave of voltage) it to come back online. This wave reaches the meninges, where pain sensing nerves are located. You feel all pain “within the brain” by the meninges.

      Migraineurs are also glucose sensitive (some intolerant) and very sensitive to insulin disturbance. Most medicines and many vitamins (including C) use insulin receptors–that was a cold shower for me as well since I am on the ketogenic diet and a simple prednisone kicked me out of ketosis throwing my glucose to diabetic level within a few hours scaring me to death until I realized the steroid-insulin connection. Serotonin and insulin resistance are twins and so any medicines migraineurs get boost their type 2 diabetes predisposition. It is well know that migraineurs are more likely to suffer metabolic disorder but scientists “cannot figure out why.”…. ‘nugh said…grrr

      In terms of your irregular cycles, in my migraine group there are many members starting pre-menopausal status and cannot tell what is coming or going. I made the following recommendation to them, which works for other migraine prodromes (such as one eye getting smaller before a migraine) as well: take selfies, date and time them, and put them side by side for a whole month.

      The reason: the female face (and body) changes considerably as she is entering estrus (fertile state). Her face becomes more symmetrical, eyes a tad further apart, cheeks a tad more red, lips a tad fuller, all pimples disappear, tummy flat, etc. This is estrogen time–also this time they cannot solve math real well and tend to get lost on the map. Then 2 weeks after this as the body switches over to female steroids (progesterone) to remove the unused uterus layer created for the baby-potential, the pimples appear, tummy bulges, face becomes more masculine, lips narrower, eyes closer, they ace math tests, and can find directions as god or better than men can, etc. Complete reversal of the changes from before.

      If you take selfies every day for a month, you can see the changes in your face. Also watch for your eyes. Few people notice this in the mirror since we see our face all the time. Even I did not know what it meant when my hubby told me “you have migraine face.” We later realized it was one eye becoming markedly smaller (this is in my book by the way) and which indicates a prodrome and that a migraine is about to hit you within a couple of hours. This seems extremely common; nearly all migraineurs have this but few ever noticed.

      In terms of your cycle, once you see the differences (place the selfies side by side–try to use same light, same hair, and before you put any makeup on) it will be easier for you to identify the time your body starts to shift into the period mode. You should keep a month of records with the selfies. You will see then when your face started to change and how many days after you noticed that you got your period. Then, knowing this approximate time frame, start increasing your salt (assuming you eat a good potassium rich diet) and also water, 5 days prior to your period based on your calculation. You may be a day or so off but will be pretty close. Continue the extra hydration all through your period.

      It is also important to not give in for sugar cravings! It is best to stop all sugar and refined carbohydrates–including rice, pasta, etc.

      Hope this helps. You are welcome to join our group–linked to it earlier.

      Best,
      Angela

  6. Hi I am 72 supposed to have high blood pressure although some readings can be 119/74 with a ramiprill 2..5 mg and statin 10 mg I am getting auras once a week any suggestions to overcome my migraine problem

    1. Hi Bob,

      I am glad you said that some readings show low blood pressure becuase that may mean you have normal blood pressure only environmental factor effect that. Ramipril is for high blood pressure so while you are taking that medicine, your blood pressure can be anything though so while you are on that medicine, your blood pressure readings will not represent the true blood pressure.

      You auras can very well be the result of your heart medicine because it acts on the renin-angiotensin-aldosterone-system (RAAS) which controls the amount of sodium and potassium in your body. Ramipril is an ACE inhibitor and as such it relaxes the smooth muscles around your arteries and heart. That can only be achieved by increasing “resting potential” meaning more potassium and reducing the strength of the “action potential” meaning sodium. Thus you are likely dehydrated. While you have high blood pressure and likely you have been advised to reduce your salt intake–and I cannot advise you in any other direction since clearly it is not my job to do so–I do need to let you know that resent research shows that reduced salt diets are actually unhealthy for even heart patients. This article may not be accessible by you but surely it is by your doctor shows that people with coronary heart disease benefit from more salt. You may want to show this to your doctor.

      The result of a reduced salt diet that is high in what is recommended in “heart healthy” high fiber carbohydrates like grains and fruit juices such as orange juice and similar plus way too much cereal and similar grains that turn into pure glucose in the body is what is causing your auras and migraines. It is best to stop all sweets and juices, talk to your doctor about increasing your salt to normal levels and as a side note, you may also want to mention statins as a problem.

      I keep on reading that for men over the age of 60 statins do nothing (only cause trouble) though I understand that most doctors today will put everyone on statins–I heard rumors that in some countries they wish to put statins into the water (not the US luckily!). You may want to evaluate it for yourself and talk to your doctor if you gain any benefit from that at all since we now understand a lot more about cholesterol and total cholesterol is quite without meaning. Even high LDL can be good since it has particles that are large fluffy (good) and particles that are small and dense (bad). Thus if your LDL is full of large fluffy cholesterol particles, lowering your cholesterol with statins can be harmful even for your heart let alone brain, muscles, and tissues. The cholesterol test you need to get is called NMR lipid profile (Nuclear Magnetic Resonance) that is usually only covered by Medicare once in your lifetime so you can ask for it, or get it separately from a lab that provides it–I got mine for $99, so not a whole lot of expense.

      I hope you can resolve your high blood pressure by stopping all sweets–carbohydrates, particularly refined ones like sugar and juices and honey and alike are responsible for both high blood pressure and also high triglycerides. A dietary change will change your heart as well as your auras. You also need to make sure you drink plenty of water. 🙂

      Best of luck!
      Angela

  7. Dr. Stanton-

    This is SO helpful for our family. We have ,unfortunately, had many generations of migraine sufferers in our heritage. It through a ton of reading that lead me to your excellent article. I have, through a process of elimination, stumbled onto a need to balance ions to mitigate our migraines. I may have missed a recommendation for my question, but is there an understanding of balancing the ratios of Ca:Mg:K:Na for migraineurs?-especially during periods of fast adolescent growth or elevated physical activity? Also, your linking low blood pressure and migraines is spot-on. The half of my siblings who suffer migraines with me, all have very low blood pressure. The other half of my family suffers high blood pressure. I appreciate any direction you can give me in balancing these ion ratios, as I do believe it is key for migraine sufferers. I am one of those folks who actually does try to calculate ionic intake through diet-your recommendations would be greatly appreciated!

    Thanks a million,

    Sincerely,

    Brian

    1. Dear Brian,

      So happy for you and your family that you are on top of things!!!

      In terms of balancing electrolyte ratios: there are no definite answers. In fact, even the most important part–potassium to sodium ratio–is questionable even though we have some guideline from the USDA. I question the ratio because of my recent research about how the USDA generates recommendations, and found that they do so with little scientific support behind those foundations. There are now several academic publications, one just published in The Lancet, the most prestigious academic journal, that the more salt one consumes, the less likely the person is to die from a cardiac event (meaning salt and high blood pressure hypothesis is completely wrong). Here is the title of that article “Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies” with a link here though it requires membership to see it all. But the conclusion is the same as many other similar studies: the less salt we eat, the higher the chance of death and illness. And what does the USDA recommend at the same time? Decrease salt in our diet!

      So, I ask you if you think that we can be certain that when the USDA recommends 4700 mg potassium a day and under 2400 mg sodium (6 gr salt), or 400 mg magnesium a day, etc., do the really know or are they just giving a number that is equivalent to a coin toss? I personally lost my trust in the recommendations of the USDA for general guideline in nutrition, so I will provide you with my experience from my migraine group, which you are welcome to join here.

      In general, I find that migraineurs feel best when their potassium to sodium ratio is 2:1.5. That means that if your diet has 3000 mg potassium (you need the link to the database for that, which you can find in my book) then the sodium should be 2250 mg that day (for reference, 2400 mg sodium is equal to a US teaspoon). Some people need more salt and some less. Medicines, weather, mood, what you ate and drank, exercise, all of these affect how much salt one needs so it is a moving target.

      In magnesium and calcium (and also B vitamins, iron, D, cholesterol, electrolyte panel, selenium) I usually ask all my migraine group members to head for a blood test to see where they stand. I so far find that while we are not deficient in magnesium (as per our USDA measures), we all benefit from about 400 mg magnesium a day–but not citrate necessarily. There are many kinds. I do not recommend taking calcium because having too much can cause trouble with strokes.

      However, I found two other important factors in migraines.

      Given that migraineurs have an “ancient brain” as a result of their anatomy, migraineurs appear to all be glucose intolerant. This is important because every time migraineurs eat something with carbs (simple or complex), they disrupt their electrolyte (Harrison’s Manual of Medicine, 18th edition, page 4). The glucose from carbs removes both water (makes them thirsty, causes edema and electrolyte disturbance) and sodium (stops voltage) from their electrolyte, which causes a migraine.

      Thus keeping electrolyte in homeostasis requires the removal of much carbs from the diet. Once carbs are removed, fat needs to replace that loss of Calories! And here is the second discovery: migraine brain needs more fat and needs animal saturated fat in particular. The human brain is 70% fat and 25% of all cholesterol in the body is in the brain forming the white matter, whose job is the myelination of neurons that are damaged from voltage. Since migraineurs experience voltage much more often, the myelin has a higher chance for damage and that needs fat and cholesterol.

      We now enter the zone of the low carbs high fat diet (some form of ketogenic diet), which is mostly made up of fat (animal saturated fats as well as vegetable fats like seeds and nuts and vegetable oils only as garnish and not to cook with), moderate protein (protein also converts to glucose) and minimal carbs. If you wish to learn more about how to change a migraine brain to be literally non-migraine brain, join the keto mild for migraine group on FB. It is new and is a learning group but so far the benefits are amazing.

      Good luck on your fight against migraines and I am looking forward to you perhaps joining one of the groups (or both).

      Angela

      1. Some necessarily brief comments about magnesium and migraines which are relevant to several of the posts here. Regarding determination of magnesium deficiency/depletion and migraines. There are currently no readily available tests to evaluate intracellular magnesium in tissue and bone, which is where most magnesium resides. The standard serum Mg test is evaluating just that, serum levels. Only approximately 1% of body Mg is in serum. Magnesium status within the cells is profoundly disrupted by alcohol ingestion, and not just through the diuretic urinary excretion. A high glucose/simple carbohydrate greatly increases the demands for Mg, yet can also cause reduced transport by insulin into the cells, and increase osmotic urinary excretion. Read vast literature on links between magnesium and diabetes. Magnesium deficiency/depletion results in dysregulation of NMDA receptor activation, a key to the pain experience of migraine, and a topic that Dr. Angela could address much better than I. Magnesium depletion can also occur in association with excessive sweating and exercise, the latter in part because of upregulated metabolic demands for magnesium-dependent processes such as ATP utilization. Anyway, more magnesium = less migraine.

        1. True Susan, thank you for your comment.

          Magnesium is increased by all migraineurs who work with me privately or via the original migraine group or the latest group with specific low carbohydrate high fat nutrition keto mild for migraine group for the reasons you mentioned.

          More specifically: magnesium holds the key to opening the pumps for each action potential (voltage generation). Migraineurs’ brain is more sensitized and fires voltage more often than a regular brain. As a result, dietary salt is increased by migraineurs to prevent energy shortage. Energy shortage leads to voltage shortage and hence cortical depression, which then leads to cortical spreading depression (the actual cause of the sensation of pain), so the increase in magnesium and potassium is necessary in the diet of a migraineur. Potassium causes resting potential, without which there is no action potential, and so equally important to salt and magnesium.

          In the Stanton Migraine Protocol® there is an emphasis placed on maintaining proper ratio of potassium to sodium in order to balance energy need and every single migraineur is encouraged to supplement magnesium. Potassium is not supplemented since most migraineurs, by nature, tend to eat high potassium diets and also because potassium in supplements does not equal (in metabolic behavior) to potassium eaten in food. So if you are a migraineur reading this: please do not supplement your diet with potassium enhanced drinks or potassium supplements. Contact us and we will guide you to health.

          Angela

  8. Angela,
    I have had migraines for about 2 years now and have desperately trying to log and figure them out. Mine happen after I drink alcohol or physical exertion. I stopped all alcohol consumption about 2 years ago and this helped a lot. but i would still get the migraines after exertion. Another symptom of mine is that if I move, bend over, go up or down stairs it is much worse pain. This last weekend I had to build a shed, this first day after just a few hours I got laid up with a terrible migraine. I had to take some sumatriptan around 2pm. the next day on a whim I drank some pedalite and gatorade and to my surprise I was fine. better then fine, I felt like the old me was back. This is what led me to your article. I need to experiment with this more. After I thought about this revelation some, I realized alcohol dehydrates you. Do you think the two are connected through electrolyte imbalance? could I of just found my cure?

    1. Hi Alex,

      If you read some of the articles on this website that I wrote explaining migraine, like this one, or read some of my academic publications, here is one that explains the connection to hydration and electrolyte but it tells you also that the sugar in the electrolyte is actually a migraine cause, you will better understand what is happening. In terms of sugar: migraineurs have a different brain, which you can read about here, and so we (I am a migraineurs too) need different nutrition from non-migraineurs.

      1) we need more salt because salt provides the action potential in our brain (and heart).
      2) we need to maintain a particular ratio of potassium to sodium in our diet because while salt (sodium Na+ and chloride Cl-) creates action potential, the resting potential is caused by potassium (K+) entering the cells. So it is not just salt but a balance of potassium and salt with water of course.
      3) migraineurs have a genetic modification that prevents proper glucose metabolism so we are at a higher risk for metabolic disorders, particularly type 2 diabetes. However, most electrolyte solutions contain sugar, which is not desired. So rather than drinking pedialyte (electrolyte for children who are vomiting or have diarrhea or are unable to eat properly) or Gatorade or any other sport drink (so called “electrolyte” but it really isn’t… it is just a ton of sugar), instead take a salt pill and drink water with that or if you can, drink whole milk. Milk is the ultimate electrolyte as studies show; here is a recent one summarized for you.
      4) migraineurs normally have very low blood pressure because they have low blood volume. If you have low blood pressure, you need to stop alcohol and all drinks and calculate how much water you need to drink a day (you weight in oz multiplied by 2 and divided by 3 is the average water you need). This only includes water so anything else you drink does not count.
      5) drinking alcohol and tea as well as herbal teas and drink are all diuretics so avoid.
      6) because migraineurs have a problem with glucose metabolism, avoid all sugary foods and drinks, also avoid all sugar substitutes (they can turn you insulin resistant in one week as latest studies find), and reduce/quit all starchy fruits and veggies (high sugar levels, fast and huge insulin spike), fruit and veggie juices, smoothies shakes, etc.

      In general, your entire lifestyle needs to be overhauled to become migraine free. To learn how, please feel free to join my migraine group on Facebook or contact me directly.

      Best of luck,
      Angela

      1. There are non-sugar/non-artificial sweetener, unflavored electrolyte water drinks out there for athletes that contain nothing but water and electrolytes. In fact I came across your website after Googling “electrolytes and migraines” because I noticed my migraines decrease after I drink these types of waters. The ingredients I look for are: purified water, sodium bicarbonate, magnesium sulfate, and potassium bicarbonate with nothing else added. So far these have brought me back from the brink of migraine pain, vomiting, and aura but now I’m interested in finding out what more I can do to help prevent and treat these awful migraines! Thanks for your site.

        1. Hi Caitlin,

          The electrolyte drinks that you drink do not necessarily have the right concentration of minerals that you need plus taking potassium in pills (or as a dilute in liquid) do not create electrolyte in your body. Potassium supplements are given to heart patients to remove water from cells to reduce BP (the entry of potassium into cells causes a resting potential to the cells and that removes both sodium and water from the cells), so taking it in that form is not a hydration but a dehydration. Companies making electrolyte drinks are pretty smart making you dehydrated so you need to drink more.

          The best thing you can do is to eat foods that are potassium rich: salmon, steak, avocado, romaine lettuce, etc., take magnesium supplements in the morning and/or noon (not at night, magnesium is a cell activity stimulant), and take salt pills or eat salt regularly with your meals, after exercise, etc., to stay hydrated.

          The natural way is always better than supplementation.

          Hope this helps,
          Angela

  9. Angela,

    Have had a problem with nightly waking, anywere from 2:00 to 4:00, with a headache that I have found is relieved, within a half an hour, by drinking a glass of water. These have occurred since discontinuing a small amount of “natural estrogen”, taken for 3 months, 1 1/2 years ago. I use 2-3 tsp. sea salt per day, don’t eat simple sugars, no caffeine, no fruit, a moderate amount of meat, moderate amount of dairy, and tons of cooked vegetables, basically following a Nutritional Balancing diet. I had my aldosterone tested and it was found to be very low, but the nephrologist said it was fine. I drink 3/4 to 1 gal. of spring water daily, but never retain any water or have any signs of edema. My blood pressure has always been low, actually too low before my change in diet. My hair analyses indicates adrenal, thyroid and sympathetic dominance patterns, although my doctor said all my blood tests look great. I take no prescription drugs, just a few supplements recommended after my hair analyses which I have every 6 months. I have minor anxiety, am 64 years old and am postmenopausal, 5’7″, 125 lbs. I did notice that when I went to a chiropractor 4 or 5 times within a couple of months, that my headaches resolved to a great extent, but gradually started to come back. Rarely do I have a headache during the day. I think my biggest problem in resolving any health problem is my lack of sleep. I can always fall asleep easily; it’s the nightly wakings that are the problem, as I can never get back to sleep. When I awake, I have to go to the bathroom, so that wakes me up further. Any suggestions on how I might keep these headaches from happening in the first place?

    1. Dear Kathy,

      Thanks for your thorough explanation since it helps me see some possible issues. Unfortunately I cannot post a picture into a comment so I uploaded the picture to my migraine-book website so you can tell me where your headache is (or you can see for yourself if what you have is migraine or what I suspect is cervicogenic). I am thinking it is cervicogenic because you improve by chiropractic treatment. Migraines and cluster headache types are not improved by any external manipulation. Migraine itself represents an anatomically different brain that needs more energy. Thus the problem that causes the pain is within electrolyte when it comes out of homeostasis.

      What stood out for me from your message though is that the diet you describe, which is indeed considered healthy in modern standards, is actually not healthy for the migraine brain. Not because the food is not healthy but because the migraine brain is differently constructed, has more sensory neuron receptor connections, uses more energy (in terms of voltage so glad you are eating more salt since that is part of the voltage ‘machine”) and is glucose sensitive.

      That means that eating carbohydrates is a problem for a glucose sensitive brain. The reaction to glucose entering into the cell (I am talking about vegetables and fruits and not just sugar by carbs) is very well defined by this quote: “…serum Na+ falls by 1.4 mM for every 100-mg/dL increase in glucose, due to glucose-induced H2O efflux from cells” (1). What this quote means is that every time you eat vegetables, fruits, grains, starches, the sugar in them converts to glucose, which then by entering the cells kicks water out (this is how your edema is created and not by salt) and it also kicks sodium out (sodium is 40% of salt and has a positive charge, chloride negative, and the two create the voltage necessary for the cells to open and close their pumps, letting sodium, potassium, and all other nutrients into the cells. So every time you eat carbs (any carbs), your cell end up dehydrated and without sodium.

      To change this, you need to apply a technique that is described in the “how to eat carbs” document in my migraine group, which you are welcome to join.

      Another factor that stood up for me is the lack of fat in your diet. While the USDA today recommends moderation in fat (especially saturated fat), it has no foundation to do so in research actually. The brain is 70% fat (yes, saturated fat!) and 25% of all cholesterol in the body is in the brain, helping neurons recover their insulation (myelin). Low fat levels in the diet of migraineurs is particularly a problem because of the extra electrical activity that causes more insulation damage to the neurons and needs constant repair. Not eating saturated fat will not allow your brain to recover.

      Whether you join my migraine group or not is up to you but look at the picture, establish what pain you actually have, and if you still think you are having migraines, please consider increasing your fats and reducing your carbs. Also, eating 2-3 teaspoons of salt may be a tad too much. The reason why you wake up with a migraine likely has to do with the fact that your electrolyte does not have the proper ratio of potassium to sodium. That ratio is very important and even a little bit past that ratio can cause migraine for those with a migraine brain.

      Hope you find this helpful,
      Angela

      Sources:
      Longo DL, et al. (2013) Harrison’s Manual of Medicine 18th Edition (McGraw Hill Medical, New York).

  10. Hi, and thank you for sharing this with all of us. I have suffered from migraines since childhood, well before puberty, and struggle because I try so so hard to do everything right. I’m an athlete and over the years have always gotten a migraine after intense workouts (rowing races) and after a nutritionist suggested magnesium that helped for my normal day to day, but not for the post exertion migraines. Over the last year,they have gotten to the point where I have passed out and in the ER they have seen that I’m slightly low in potassium. I suspect I also don’t get enough sodium because I have avoided processed foods for years and even use unsalted butter. Do you have an app you recommend for tracking hydration and electrolytes? I’m worried about overdoing some and overlooking others. Thank you!

    1. Hi Jeanethe,

      I totally understand. Basically you have two options.

      Getting your electrolytes completely out of balance is very common for athletes. You can choose the easy way and just take an electrolyte pill that is only salt and perhaps a tad potassium (and iodine if available) with a glass of water. Don’t ever just drink pure water during workout. Whatever you drink during workout needs to be salted water. You perspire salt as well as water–not so much potassium so that can be ignored in terms of replacement while working out. Potassium is needed in order for the sodium to release the water it is holding onto and magnesium is the “key to the voltage gate” so to speak so you do need all 4 but not at once.

      Option 1) take a salt pill (at least 360 mg sodium or larger) and a glass of water about 1 hour to 30 minutes before your workout. Drink salt and water (about 1/8th teaspoon salt in 24 oz water) during your workout and salt pill and a glass of water after your workout (a salt pill is just about 1/8th of a teaspoon of salt). Don’t load carbs or protein up front. Athletes who carbs and protein load often end up with type 2 diabetes. This research is new but we already have many athletes with type 2 diabetes at a young age so the connection is clear.

      Option 2) the latest high energy workout that is low impact workout is based on fat burning diets and not carbs burning diets. These scientists have taken it a notch up from everyone else. There is a video plugged into Mercola’s article here. I did not read the article but have watched the video and went to the website to purchase their full video–which I recommend you do too–and the books of the scientists.

      This video shows you a couple who decided to row from California to Hawaii only on fat and low carbs like dried vegetables, seeds, nuts, etc. I did not see any meat but they may have had some dried meat as well. Working out (for 45 days, 14-18 hours a day) on low carbs and high fat (many variations exist on this ketogenic type diet) you don’t disrupt your electrolytes because that only happens when you burn carbs. You merely need to replace salt water to replace what evaporates in your sweat.

      In my migraine group, I recommend to everyone to reduce their carbs intake and increase their fat intake (and I don’t mean coconut oil (MCT) but fat as in butter, whole milk, cream, cheeses) in order to allow for fat that “builds up for energy” (LCT) whereas coconut just “burns up like instant energy” so there is a difference.

      Magnesium is an important element in workout as well–usually taken after the workout and not before. If you cramp up, it signals not enough sodium. If you get muscle ache it signals not enough magnesium. If you drink a lot of salted water but your urine is colorless like water, you need potassium–however, do not take potassium supplements since that does not help electrolyte the same way as potassium from food does and can be harmful for your heart.

      I hope this helps. Please join the migraine group if you need more help. 🙂

      Bets of luck,
      Angela

  11. Hi Dr Stanton,
    I live in the UK, and I suffer from a neurological disorder induced by exposure to LED solid state lighting or modern LED screens on televisions or mobile phones.
    This idiosyncratic response quickly resulted in migraine symptoms of pain, dizziness, headaches, and lack of cognitive ability that seems to be triggered by the LED lighting. This has obviously had a dramatic effect on my working life, I experience these migraines every day when at work. This has unfortunately been the case since October 2013 when the lights were installed at work.
    Before my exposure to these LED lights I had never experienced a migraine. I had experienced headaches previously. My reaction to these lights continues throughout the evening also. I generally feel OK at the weekend or holiday breaks away from the office as long as I am not exposed to LED solid state lighting at any point in the day.
    I have had a brain scan, have seen ophthalmologists, optometrists, neurologists – all without any positive outcome with regards to preventing these migraines from being triggered when I am exposed to LED lighting. This reaction also happens in shops with LED lighting and viewing LED screens such as televisions and mobile devices.
    I have previously been prescribed Amitriptyline, and Sodium Valproate from my Neurologist consultant. Both did have some effect initially, but unfortunately did not prevent the reactions, and after time were not effective.
    I am currently medication free and do not take any pain medication.
    I have been in touch with a few people who are experiencing the same issues as myself with LED lighting, a charity regarding the negative health effects of LED lighting is at the moment attempting a start-up for greater recognition of this condition. https://chuffed.org/project/lightaware.
    If you have any suggestions as to a possible course of treatment I can pursue I would be most grateful.
    Many thanks,
    Andy

    1. Hi Andrew,

      I am glad you are medication free. What you describe seems to be classic migraine. I have not heard from others about LED light problems but perhaps it is just too bright and white for you? It does not flicker like fluorescent lights, which are major migraine triggers, but perhaps your eyes are just that sensitive.

      I found that migraineurs don’t seem to be able to close their pupils as tight as non-migraineurs can. I wrote about that in an academic article and also now in the second edition of the migraine book I am finishing (Fighting the Migraine Epidemic is the first edition that in the UK you can find at amazon UK here for paperback, and here for e-book that says kindle edition but comes with free software/app for all platforms).

      The book should help you understand why you are sensitive to light and what you need to do. For more specific discussion please join the migraine group on Facebook or contact me via PM. There is a solution that works for all primary migraines so far without exception and there are no medicines or supplements involved. It may help you too.

      Best wishes,
      Angela

      1. Hi Dr Stanton, thanks for the advice. I’ll make sure to get a copy of your book.

        Through my previous research I have found that in fact LED lights do flicker. Without trying to sound like a conspiracy theorist, We (the general public) have been reassured that new LED lighting technology does not flicker as compared to say florescent lighting, but this is simply not true (they are cheaper to run and this is probably a very good reason why the general public have not been told the complete facts). An initial report on the subject can be found here: http://bit.ly/1iL2vjq.

        The risks include seizures, and less specific neurological symptoms including headache, dizziness and general malaise. Seizures can be triggered by flicker in individuals with no previous history or diagnosis of epilepsy.

        Apparently the LED lights with bad drivers flicker at an imperceivable level that cannot be seen with the human eye, the brain however is still detecting this flicker and this in turn triggers a migraine – much like in epilepsy. I only know this because I have been exposed to these lights on a daily basis and have been afforded the opportunity to attempt to understand the process of why these lights have affected me in such a way.

        I think this is only partly the reason why the new LED lights are affecting me, other factors include colour spectrum emitted – harmful blue light – http://www.bluelightexposed.com/.

        Hopefully this information will be useful to others (and perhaps
        interesting to yourself) who are unaware of the condition and may be suffering without knowing the cause or trigger of their migraine condition.

        This new technology and it’s effects on human biology are not yet fully understood. The majority of people thankfully do not seem to be affected, but this does not make this technology safe for the few short-term, or the majority long-term

        Best wishes for now, Andrew

        1. Hi Andrew,

          I agree that there is much to be learned yet about LED and how our body is affected. The “blue light” phenomenon is already understood and, for monitors at least, that is resolvable by a software called f.lux that changes your monitor’s colors according to how natural light changes outdoors. In terms of the flickering, I will read the paper you attached. I know very little about that but really it is not important at this moment since that may be a very long battle and you have migraines now. What is important is that it bothers you and you need to avoid the pain until the science catches up.

          As you are now member of the migraine group, you will see that once your brain is properly nourished with the right electrolyte homeostasis maintenance, no matter what you do or what you eat you will find your sensitivity will reduce and over time vanish.

          The migraine brain is a unique one. Its anatomy is very different from the brain of a non-migraineur. I recommend you read two articles in particular: one on the anatomy of migraine-brain that I wrote for this website 2 years ago here, and one I published in an academic journal that I may have linked to earlier, not sure, here.

          Reading these will make you see what the problem is and now that you are in the migraine group, we will help you overcome the problem with the LED light without touching the LED light in any way.

          Looking forward to helping you resolve your sensitivity there. 🙂
          Angela

  12. Thank you for a thought provoking article and book. My 18 year old son is currently completing his last year of high school and is often getting migraines with a persistent visual aura. It started following a bout of glandular fever.
    Some of his stressors seem to be high sugar content, strenuous physical activities and lack of sleep. I have noticed that he does have puffy eyelids at various times. He has become gluten free. I was wondering if he should be starting and ending his day with an electrolyte drink that you have recommended in your book.

    1. Dear Robyn,

      Thank you for using the book; I am glad to help. In the book I refer to an electrolyte that I created for my husband (not a migraineur) when he got Montezuma’s Revenge in another country, where I had little access to anything. With a GI problem like Montezuma’s one loses a lot of fluids and also sugar from vomiting and diarrhea and so full electrolyte is a necessary healing component. That is not so for everyday living. Sugar is a very serious migraine trigger because glucose removes water and sodium from the cells, leaving the cells without the ability to generate voltage. Sugar (in electrolytes) is thus not only not needed but is harmful.

      I recommend he end his days with a glass of whole milk (if he can tolerate it) or cheese or a bite of some meat and fruit and about 30 minutes later a salt pill (1/8th teaspoon of salt) with a glass of water making sure this is at least 15 minutes before he lays down flat. This will help him through the night of sleep, which, for a migraineur (and for most others), is a long fasting time of no food and no water. Then, in the morning, before he even steps out of his bed and at least an hour before breakfast, another salt pill or 1/8th of a teaspoon of salt and a glass of water. For breakfast please avoid all cereals and provide wholesome foods like bacon and eggs with potatoes or avocados, tomatoes, or a little fruit for some carbs. No fruit juices at all please.

      Gluten free grain alternatives have higher glucose content than their gluten counterpart. The glycemic index (insulin spiking index) of corn or rice flour baked goods is significantly higher than actually eating sugar (corn is 100, which is the same as pure glucose whereas sugar is only about 55!). So going gluten free is a problem. If he is gone gluten free because he is sensitive to gluten, it is far better to go completely grain free (I am grain free). You can find all the grains listed in this article. Some seeds, like buckwheat, have been given the unfortunate name of wheat and grain, neither of which is true, though buckwheat is tremendously high in carbs so recommended only very seldom and in small amounts.

      However, with all this said and done, it is not just sugar but all carbs matter–including fruits, vegetables, nuts and seeds. To get a better understanding on how to eat carbs safely, please join my migraine group (not private but free) or contact me on my private page for alternate options if you prefer privacy (not free).

      I hope you find this helpful.

      Best wishes,
      Angela

  13. Hi Dr. Stanton,

    Thank you SO much for your article. I am 36 and have had chronic migraines since I was 6 years old. Over the last 3 months they have increased in their frequency and have become progressively worse pain-wise. About 6 months ago, I cut refined carbs and sugar out of my diet and eat mostly protein, fruit, and vegetables. I spoke to my Neurologist to tell him that I thought I was dehydrated and asked if he could administer an IV solution to raise my hydration level to baseline. He wasn’t able to give me an IV; however, he confirmed that migraneurs are deficient in magnesium and that too much water can actually flush the salt that I need. My question for you is this: Can you provide the recipe for making the electrolyte solution that helped you? I don’t really want to introduce sugar into my diet again with Gatorade or Pedialite, but I will do it if that’s what will help. I definitely don’t want to take the lower (fake) sugar versions because those are a migraine trigger for me. Any advisement you can provide is greatly appreciated!!

    Kindest regards,
    Julie

    1. Hi Julie,

      Congratulation for cutting refined carbs from your diet!

      I can see a bit of problem with eating mostly protein. Protein converts to glucose in your body via gluconeogenesis if you are not eating enough carbohydrates so if you cut complex carbs out of your diet too much (women need 50-70 net grams for weight loss, 71-150 net grams for weight maintenance, and over 150 for heavy workout and weight gain) you actually enter the protein conversion process, which is a very expensive process for the body and can hurt your liver. Instead of increasing protein, you should consider increasing fats in your diet–not just vegetable fats but animal fats as well. Our brain is 70% fat and 25% cholesterol. There is not a cell in your body that does not have a lipid (fat) membrane. Thus we are made of fat so we must eat fats that can add to our cell repair. Myelination (insulation) of the brain cell’s axon, the part in which electricity travels, is made with cholesterol–this is the white matter in your brain. If you are not eating fat, you are not able to repair your axons’ myelin. That is cause for concern, particularly in the brain of a migraineur, where migraines and more frequent sensory neuron use damage the myelin of neurons. You need to have a chance to repair that damage.

      However, you do not need sugar (or any refined carbs) in your diet or drink at all! In fact, in my FB migraine group, the first thing I ask everyone is to stop all sugar and sugar substitutes! By this I mean all added sugar of all kinds; naturally occurring sugar in fruits or vegetables is fine in limited amount. In my book I describe how I made an electrolyte solution to my then sick husband (not a migraineur), who had Montezuma’s Revenge at the time and we were in another country. Montezuma’s Revenge is accompanied by vomiting and diarrhea and thus the whole electrolyte needs to be replenished but that is not necessary in your everyday electrolyte management.

      I have a couple of published articles that specifically detail that migraineurs are glucose sensitive so you definitely do not want to introduce sugar into your diet. Here is one of those articles that detail what you need to do and why. Your doctor is correct about flushing nutrients out of your electrolyte if you drink more water than what you need and also because, as a migraineur, you actually use more of some of the minerals in your electrolyte than non-migraineurs. Migraineurs have a very different brain anatomy that uses more voltage. Migraineurs also have functional prodromes (different from what you know as prodrome!) so here is another article I published that explains what functional prodrome means and how you can tell where you are in your impending doom of getting a migraine. You can prevent all migraines by knowing what your prodrome means and how to act immediately. You have quite some time between a functional prodrome and a migraine-pain.

      Feel free to join our migraine group or contact me via the contact form here.

      Best of luck,
      Angela

  14. Wow! I cannot thank you enough for this information. My 16 year old daughter started to get chronic migraines last year. Tried Elavil, she hated it, but got some relief. Tried paleo + coconut oil + Mag + riboflavin, worked for a while, then relapse. Now Topamax, which she likes due to weight loss (being a teenager). But still breakthrough migraine mid-cycle and during period. We knew carbs & sugars contributed to onset from food logging, but I thought blood sugar. Thank you for explaining how sugar purges salt from cells. Ah-ha moment. We will be adopting the electrolyte protocol pronto!!!

    1. ….oh, forgot to mention. her initial onset included rapidly expanding food allergies. She started to react (itchy mouth) to apples, then many tree fruits, then cilantro, almonds, even raw carrot. As she became more allergic migraines went from 1 per week to daily over 6 months. Not generating IgG itch response, but food trigger for migraine directly are gluten and egg.
      Is all this hypersensitivity and low sodium somehow also linked to elevated histamine/allergy response???

      1. Maddy, I had the same findings on me. GF though is not enough. I discovered that going grain free, all my other food allergies went away but GF meant some foods like rice and corn were still in my diet and my allergies continued. I discovered that I needed to remove all grains in order to be free of allergies–which I now am. I stopped my allergy medicines about 6 months ago and have been able to return to all of the foods I could not eat before.

        In fact, I now find that if someone does not tell me that there is any grain (even GF) in the food they serve me, I can tell they put something in there because it initiates an allergy (asthma) cough!

        French fries made by any restaurant (be it fast food or not), hash browns, shredded cheeses, soups, gravy, any sauces, soy sauce too, all contain some grain. The other day I ate pork crackle in a restaurant (why would that be dipped into any grain flour??) and started a cough from the first bite! Read this article on what are the real grains. Some have names that we think are grain (like Buckwheat is always sold as grain but has nothing to do with being grain) and in other cases like corn we don’t think of it as grain and it is not when eaten on the cob but it is grain to the highest degree as a dried corn GF food alternative and really bad for the gut and food allergies. Same with rice! It has no gluten but is full of sulfur and arsenic and is grain!

        She needs to go grain free completely. You may also want her to know that going grain free will actually make her lose a lot of weight! Today, most people have over 60% of their carbs intake made up from eating grains that have no nutritional value (grains prevent nutrition absorption! Cutting that out means 60% fewer carbs so she will lose a ton of weight and can eat healthy carbs alternatives like fruits and vegetables instead (always eat whole fruits and not juices, shakes or smoothies of any kind).

        Since I went on grain free life, I am losing about an inch per month off my waist line, showing that my body is dropping fat it retained from all the grain I used to eat. I don’t have much more to go because I am not overweight but a little bulge here and there disappearing is always great! Once she is on reduced carbs like this, please increase her fats. Fat, particularly animal fat, is a very important source for the body’s natural healing system. The brain is 70% fat and 25% cholesterol. Eating vegetables we cannot make the right types of cholesterol so eating animal fats is an important healing factor for the brain.

        Good luck,
        Angela

  15. Hi Dr. Stanton,

    This was a very eye opening article! I have suffered from migraines for over 20 years. The began with the onset of puberty, and were accompanied by aura every time. I know part of the issue is hormonal related as I would migraine within 2 hours of delivering my babies (of which I have 5) My 4th and 5th pregnancies that were carried to term, I had pre-eclampsia. It got quite severe, and after my last baby, I was left with BP that needed to be monitored on a regular basis. I began cutting out salt, refined sugar, and exercising on a daily basis. This helped with the BP issues, and also seemed to help a lot with the migraines. I went 6 months migraine FREE! But since Christmas, when I fell off the wagon and was eating sugar, even though in January, I cut it out again, I have had monthly migraines. There seems to be no apparent trigger this time EXCEPT that after a migraine, I CRAVE salt. Like that is the only thing that I NEED to have. I need something like an Ichiban noodle soup to satisfy my craving. This particular week, I have jogged over 5 miles and today I was hit with a migraine- aura, heightened sense of smell, nausea and head pain. I finally googled “salt and migraines” and read your article. Now I wonder if I am too low in salt! Do you have any input as to how I can balance my BP AND my salt? Thanks for your insight!

    1. Hi Meredith,

      I am very sorry to hear about your blood pressure increase during pregnancy–unfortunately it is more common than most people realize. I am happy that you have done the right things for your recovery. In general many doctors, especially those who learned their medical art many years ago, support the theory that salt increases blood pressure but actually sugar is the guilty party. Studies that show salt increasing blood pressure are numerous but they all studied salt in the wrong context and set up their experiments the wrong way. I discuss this extensively in my article but in short I can explain why there is still a lingering belief around that salt is at fault.

      We have a body fluid that is part of our blood: electrolyte. Electrolyte is a vital fluid that is made up of water and several minerals: salt (as sodium and chloride ions), potassium, calcium, magnesium and some other elements are included in this vital fluid. Sodium ion flows in and out of cells via special voltage gated sodium channels (there are many types of channel) and their primary role is to generate an action potential in the cell so that the cell membrane can open its channels. When that happens, potassium rushes in and brings the cell to resting potential. Thus cells vitally need sodium (positive charge inside the cells) and chloride (negative charge outside the cells) to generate voltage. You cannot survive without this voltage. However, sodium also loves to hold onto water.

      In terms of hydration, it is important that you have salt in order for the sodium to hold onto water and hydrate you. A hydrated electrolyte (in the blood) is a heavier, volumized, electrolyte so your blood, weighing more and taking up more space than when you are not hydrated properly requires the heart to pump harder, i.e. with increased blood pressure. However, just like a weight lifter eventually creates muscles to lift a particular heavy weight with little effort, we must remember that the heart is a muscle. Thus if your blood is always volumized to its fullest and healthiest, your blood pressure will return to normal after your heart is used to pumping volumized blood. This has been proven by thousands of people in my Facebook migraine group, where no one’s blood pressure increased as a result of a well-hydrated body by increased salt intake, provided that with that one drinks the right amount of water and also does not skimp on potassium that is also required for the cells’ proper function.

      Thus, as you can see, salt retains water inside cells to hydrate the body. Now let’s take a look at what sugar does. I have a book titled Harrison’s manual of Medicine and on page 4 it states the following about what happens when glucose (sugar) enters the cells “…serum Na+ falls by 1.4 mM for every 100-mg/dL increase in glucose, due to glucose-induced H2O efflux from cells”(1). In this particular quote there are two particular parts of importance as it describes what happens when glucose enters the cell:
      1) Na+ falls – this means that glucose removes sodium from the cells
      2) glucose-induced H2O efflux from cells – this means that glucose kicks water out of the cells

      Thus when you eat sugar, you chase water and salt out of your cells, dehydrating the cells but it says little about where the water and sodium it removed ends up. Next time you eat some sweets, in about 20-30 minutes see if you can turn your ring on your finger or if you get a sock line mark on your legs. Press your ankle to see if you have any edema (if you do you will see the skin pop back slow). Sugar causes edema. Edema is weight on the outside of your cells in your blood vessels and also outside of your blood vessels deposited–swollen eye lids or puffy under eyes are all edema as well. Having edema is indeed very hard for the heart to work with because your blood is not hydrated enough and the little volume of blood you have has to be pressed against the weight of the outside pressure and this causes high blood pressure.

      Sugar also causes metabolic issues plus if you eat much fructose (in all added sugars, all fruits and fruit juices and some vegetables), the liver converts fructose to triglycerides, the type of cholesterol that causes blockage of the arteries. Now this greatly increases blood pressure. Furthermore, because sugar chases both water and sodium out of the cells, sugar will make you thirsty, which then dilutes the electrolyte mixture you have, further reducing the concentration of sodium and thus interrupts the voltage system of the cells. This voltage-system breakdown leads to migraines. I have written two journal articles on this subject, one introducing the cause of migraines and the other discussing some of the functions prodromes have.

      I hope this answers your questions. If your doctor has any concerns about salt, please print out this and the linked articles so that your doctor can make a decision based on the most recent research and not an old myth.

      Angela

      1. Longo DL, et al. (2013) Harrison’s Manual of Medicine 18th Edition (McGraw Hill Medical, New York).

  16. Hello Dr. Stanton, I am looking for information on persistent visual auras, because of it’s rarity and the wide variety of symptoms it is difficult to get really concise information on it. It has been suggested that my daughter who is now 22 and has had migraine with rather extreme auras on occasion since the age of 12 is experiencing this condition. It started after a viral infection with a high fever, it came on suddenly after awaking and ingesting an entire packet of Emerge-C immune+ without water. Within 30 minutes she began to notice spots in her vision and then took aspirin but instead of getting an extreme headache the spots engulfed her vision. We went to the E.R. and she received an I.V. and ibuprofen and was told to see a neurologist if it persisted. After about 12 hours the swarms of spots were gone but she was left with bilateral spots or scotomas? also increased light sensitivity, flickering and flashing, halos and increased after images. Some of the intensity of these have improved over time but the spots(scotomas) have remained. An eye exam showed everything in her eyes were normal expect for a decrease of vision in these spots and she was referred to a neuro-opthamologist. After another field test there showed no actual blind spots we were told that M.S., stroke, and brain tumor could be eliminated and the diagnosis was Persistent Aura. After exhaustive research my daughter feels that her symptoms don’t exactly fit this diagnosis and has requested an MRI. and I might add that she is terrified and has convinced her self that it will reveal a dire prognosis. I am heart sick to see what has happened to my daughter who no longer can even see a future for herself, I have also put all my time and energy towards investigating causes and cures with no real improvement over these weeks. She will be having the MRI in about two weeks from now and I’m praying that this can be resolved by then, I appreciate any information you may have on the subject. Thank you, Tracy.

    1. Hi Tracy

      I fully understand your concern. I am out of the country until the start of March. Would it be possible for you to send an email to my email? I will remember then to respond to you when I return and by then your daughter will have had her MRI that I suspect will be totally normal. My email: angela@angelastanton.com and I will respond as soon as I am back in the country. In the meantime, if she eats any sweets, drinks any smoothies, shakes, juices, please have her stop those. This will already help. We will discuss the rest after I am back.

      Hugs to both of you,
      Angela

  17. I still have the one BIG question: why are we getting dehydrated to such an extent? Dr. Stanton, you seem like a perfectly normal person in terms of your lifestyle – what is causing your dehydration to begin with? This seems to be the big mystery.

    I am a middle aged woman who doesn’t do marathons, eats a relatively healthy diet, gets 7-8 hours sleep and leads a life that doesn’t involve horrifying levels of stress. If I am getting dehydrated, what is causing it and what can I do to step back into that problem and solve it?

    Thank you!

    1. Hi Susan,

      If you read some of the other migraine related articles I wrote at this website, together with the article I published, and my book Fighting the Migraine Epidemic, then you will see that migraine brains are different from other brains and they use much more energy, which for the brain means electrolytes. Thus by hydration I mean electrolyte components: water and salt that together help create voltage with potassium. Salt is critical for voltage in the brain so is water. Hence this article on hydration.

      Not sure how you hydrate yourself. Most people I talk to understand water as hydration. Water is not hydration. Water is only part of it. Of the over 4000 people I so far helped with migraines, the majority neither drank enough water nor ate enough salt.

      Hope this explains the problem. One additional tidbit: if you don’t have migraine brain, lack of proper hydration will not cause pain. For migraineurs it does.

      Angela

      1. OK! I am not a migraine person, but this article seemed so related to my own situation. So, I hadn’t read your other materials, my apology.

        I think I get what you are saying: brain power needs “fuel” and that is the crux of the issue. I will think long and hard (which will require more brain drain – :)) and see how it applies to my situation. You have provided valuable insight.

        1. Dear Susan,

          Glad it helped. If it is any more help, there are many people who use my hydration process who have no migraines. Proper hydration is essential for healthy cells in general. The media is very misleading.

          When a famous talk show host says your urine needs to be clear, half of America heads to get clear urine and that is wrong. Clear urine means you are not getting the water into your cells no mater how much you are drinking and you can actually get hurt.

          Not sure what your health condition is, but I have pulled a few people back from near water toxicity. So be careful “how” you drink, what you drink, and how much you drink. 🙂

          Good luck! Feel free to ask any questions.

          Angela

  18. Thank you so much for your research. I had done a lot of research on my own, but until I got my diagnosis of genetic migraine, my research didn’t really go anywhere. A big clue was when I tried to live in the high desert – my electrolytes never came into balance. I now believe that sea level is the best for the migraine brain.

    I have all of the sensory enhancements you mentioned in your research. My attitude is that it is a gift. I am not the standard version human, I have a lot of extra bells and whistles. So, even with this great nutrition and hydration attempt, I am not going to go where there are crowds, noise, perfumes, vibrating or screeching machines, verbally abusive people (including several doctors), etc. (BTW – My symptoms improved by 50% after divorcing my verbally abusive husband).

    This avoidance of the triggers and stressors leaves me with more energy to do what I want to do with my life.

    Salt helps me so much. It’s amazing. Even ibuprofen makes migraine brain worse. So, I stopped taking it years ago and am committed to not taking any drugs at all.

    I wanted to say calcium and magnesium are also electrolytes. Since I get worse in winter and an overcast sky brings on an increase in symptoms, I figured that Vitamin D was a problem. I have started Vitamin D3 (with food sources of calcium – full fat yogurt and corn tortillas (made the old-fashioned way “with a trace of lime” – as in limestone). I am also doing epsom salt baths (magnesium-sulfate). In addition, a healthy amount of sunshine whenever the sun comes out.

    1. Dear Cathlyn,

      Thank for your comment. I agree with most of what you say except the sea level comfort only.

      See when you travel up to higher altitudes (or a low pressure weather system moves in) your body “expands” under lower pressure. This is the time to increase water and salt to fill up the “empty” space so does speak. Once you do that, you are just as comfortable in high altitude (low barometric pressure) as at sea level. High pressure (as in hot weather coming or going the Death Valley or diving for example), requires the opposite and instead of increasing salt and water you need to increase potassium rich foods to reduce the pressure in your body so the outside pressure acting on you is not painful.

      Thus things can easily be controlled by understanding what causes what. This is subject in my book as is how to travel since flying by air is equivalent to high altitude low pressure so you need to apply the same principle. There are additional topics covered about foods that trigger and how to match those foods with other foods to cancel out the trigger. Thus for “my” migraineurs, there are no food triggers except for sugar.

      It is also important to note that those following my protocol have mastered the painless handling of noises, strong scents, light, etc. It is totally possible once you treat your special brain as you should: in a special way. <3 I agree; I LOVE my special brain for all of its special attributes. Mine saved an entire city from blowing up during an earthquake. We have special gifts. I am anti-medicine becuase all medicines prescribed for migraine do one thing: reduce our brain’s ability to be those of “average” brains and we do not benefit from that–let alone the fact that those medicines do not actually work. 🙂

      Hope you have a great and painless day!
      Angela

  19. I used to get migraines with aura several times a month as a teenager – increasing to a weekly event around the age of 18. One evening, after playing football (soccer) with friends for almost 3 hours I experienced the familiar aura and vision loss as I walked home and went straight to bed to try and get to sleep before the headache started. I woke up an hour later and had lost all speech and hand co-ordination. I sounded like Serene Branson in her famous YouTube video where her words were all slurred. My parents thought I was having a stroke and rushed me to A&E, by which time I had regained my ability to speak. After an MRI showed no brain damage my Neurologist noted that my migraines seemed to happen after physical activity and suggested that I eat something sugary such as a chocolate bar immediately after exercising in case my blood sugar had dropped too low and was causing the migraines. This seemed to work (I ate Mars bars) and I didn’t experience another migraine with aura for 18 years. Then, I experienced one in 2010 but hadn’t been exercising and now that the internet was available I started searching for possible answers and discovered some folks who seemed to think that electrolytes might be the issue. I had been working in France in the hot summer sun and had also reduced my salt intake that week when my parents came to visit. This also made sense to me given how much I sweat during exercise (a lot!) I decided to experiment on myself. Instead of eating a chocolate bar immediately after exercise, I started drinking sugar-free electrolyte drinks and sure enough I didn’t experience a migraine until the one time I didn’t take in sugar or electrolytes. I’m pretty much convinced electrolytes are the cause of my migraines.

    1. I agree Richard in that electrolyte imbalance causes migraine pain but only in those with a migraine-brain.

      There are many people who even get hurt (some even die) after heavy exercise and lack of proper electrolyte–as Marathon runners who need hospitalization and sometimes don’t make it. They may not get a migraine but shiver uncontrollably even in heat. A single salt pill with a tad potassium (without water) can resolve the issue.

      But they do not have migraine.

      To get a migraine, particularly with aura, you need to have a migraine-brain. Migraine-brains are sensitive to electrolyte imbalance all the time and not just after workout and migraineurs also are glucose sensitive (glucose interrupts electrolytes). I found that low carbs and well-balanced electrolyte of a slightly higher than normal sodium to potassium ratio is the ideal mix for migraineurs. In my migraine group of several thousands, this is well demonstrated. As new members stop sugar, reduce carbs and increase salt in a more balanced diet also full of potassium and drinking ample water, migraines come to a halt. Migraines can be prevented and treated well with electrolytes (assuming sugar is not consumed). Migraineurs stop all of their medications once they no longer have migraines.

      I have an academic article published on this (written in an easy to read language) if you are interested in the Journal of Mental Health in Family Medicine:

      http://www.mhfmjournal.com/mental-health/migraine-cause-and-treatment.php?aid=7552

      Best wishes,
      Angela

  20. In reading most of people’s posts their migraines seem to be tired to some external onset cause such as overexertion, hormonal changes, food triggers, etc. My migraines are complicated migraines due to a traumatic brain injury. I’ve had them for 24 yrs. They cause focal onset seizures, upwards of 17-18 migraines a, month, 7-8 of which cause me to pass out and sometimes re injure my head. Botox treatment merely made them worse. How can a migraine brought on by brain damage react positively to treatment designed to fix migraines basically brought on by chemical imbalance?

    1. Hi Sheri,

      Sorry to hear about your condition. The migraines you have are extreme headaches brought on by brain injury. Migraines require a person to have a unique component in the brain: multiple sensory receptor connections. Not all very serious headaches are migraines. Migraines need not come with pain but they have prodrome. They always do. The kind of pain you describe seems to be horrific pains that may in fact be related to seizure activity in the brain and may be cluster headaches rather than migraines.

      Cluster headaches are more painful than migraines and your passing out from pain makes me think perhaps you have cluster pain. By now my migraine group had over 4000 migraineurs pass through and all have migraines lasting 3+ days each. So having 17+ migraines a month is not possible based on the limited days in the month. Rather people with migraines are likely to have say 17 migraine days such may be 5 migraines lasting 3+days each.

      Nonetheless, even migraines don’t respond to botox in the majority of cases because only one type of migraine responds: trigeminal. Most migraines are not trigeminal so botox does not help. Migraines have marked prodrome that you did not mention.

      With this all said and done, there is a person in my group with similar situation to you. She had a horrific car accident in which she damaged her brain and also damaged her spine and jaws and just about every body part possible. She joined the group about a year ago. I did not think we can be of any help. She was also taking over 30 medications and had mini strokes just about every other week. Even her typing was slurred during a mini stroke time so we could see the mini stroke and send her to ER.

      She went on the protocol which is a lot more than just hydration. It also involves carbs control so all sweets, including sugar of any kinds, even honey, sugar substitutes, juices, smoothies, shakes, tea, and alcohol need to be stopped. Glucose from sugar disrupts electrolyte, causing dehydration. Sugar substitutes must also be stopped so no sweets at all. Teas are diuretic and work against hydration so they too must stop.

      In addition to stopping all these, and drinking only water with no flavoring at all, the most important in hydration is the proper potassium to sodium balance. Studies show that too much potassium induces seizures and that is the reason why a food full of potassium, such as dark chocolate, is a migraine trigger. Migraines and seizures have much in common. By eliminating the imbalance, the seizure component is eliminated as well as the trigger caused by the out of balance chemicals.

      Back to the person with major brain injury and mini strokes with over 30 medications: she reduced the medicines with her doctor’s guidance after I pointed out the many overdoses and adverse drug interactions. She is titrating slowly and is now taking about half of the dose of everything and some were stopped. She keeps to the protocol in full. She had not had a mini stroke in several months and now can walk again and can leave her home for therapy and some hobby activities. Most importantly she is migraine free!

      Her awe inspiring story is our group’s biggest success against all odds. We watch her (I say we because the group is like a giant family in which we all help each other) like a hawk and jump into action if we notice any changes. Lately we have nothing to do. She is in the UK and we even have some locals to her in the group on watch to contact her if we don’t hear from her for a day.

      I think that if we could help her, we can help you. The protocol of proper hydration and carbs control benefits everyone at every age. It reduced blood pressure for members who joined with hypertension; it reverses prediabetes and possibly diabetes 2.

      A healthy lifestyle is good for all. This particular lifestyle with complete sugar removal is amazing for migraineurs because after a member is migraine free for about a month, I encourage that they eat some candy. Without exception a migraine follows because of what sugar does to hydration. 🙂 It can help you too.

      I hope you find this helpful. Best of luck to you.

      Angela

  21. At 64 I experienced my first two aura migraines about 18 months ago and then nothing until recently. I exercise quite hard and sweat alot but drink around 2 litres of water and so thought I was fully hydrated. I was getting aura migraines only after exercise at almost exactly the same time every time. The gym guy suggested I try electrolyte powder and after two successive gym visits no aura migraine. So I feel sure about this cure.

    1. Hi Ken,

      Great that you went after electrolyte! Indeed that is what you needed. We evaporate salt and water in our sweat. You really only need these two after exercise for a regular workout but for extra heavy workout magnesium, potassium and some phosphate are also important and water of course. You made the right decision! 🙂 Glad your auras are gone. If at any time you get auras even without exercise, you still need to grab your electrolyte. Environmental changes like weather, full moon and stress can cause overactive CNS causing you to use up more salt and water than usual, hitting you with a migraine. Aura without pain is silent migraine. So keep your electrolyte near at all times. 🙂

      Best wishes,
      Angela

  22. Roz,

    Please make sure you do not just “quit” taking Nerontin. You need to follow doctor’s direction for reducing. It may take quite some time to stop a medication like this. Stopping it all at once may give you seizures. So please be careful! And thank you for getting my book! <3

    Hugs,
    Angela

  23. Thanks so much for taking the time to list the studies. Sounds like Neurontin is very bad for what little plasticity is left in adults and aging adults, and pregnant women should never, ever take it. Wow. I’ll definitely check out your book 🙂

    Roz

  24. Hi Roz,

    Actually Neurontin is not FDA approved for many of its uses, such as pain or others usually prescribed for. Until a drug in not approved for a particular purpose, its use and possible damage it may cause is not officially studied–after all if it is not approved to be used for something why study it? The fact that it is actually used off label for many things is obviously swept under the rug and is irrelevant.

    I found some information for you that support the brain damage argument.

    First, here is a link to a PDF on the FDA website that lists the FDA approved use for Neurontin. There are two FDA approved uses: Postherpetic Neuralgia (shingles) and as an “ad-on” for seizures and NOTHING else!

    Thus the prescription of it for other uses, such as migraines, fibromyalgia, etc., are all off-label–something I discussed earlier that I highly dislike.

    For your own education, here are a few links for you:

    FDA prescription labeling: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020235s050,020882s035,021129s033lbl.pdf

    An interesting article: http://www.peoplespharmacy.com/2012/05/26/gabapentin-side-effects/

    A Stanford University research: http://med.stanford.edu/news/all-news/2009/10/study-pinpoints-key-mechanism-in-brain-development-raising-questions-about-use-of-antiseizure-drug.html

    And from a board certified clinical nutritionist: http://www.wellnessresources.com/freedom/articles/neurontin_and_lyrica_are_a_death_sentence_for_new_brain_synapses/

    There is also a database that may be difficult to see or understand but it lists the number of cases in which the brain was damaged one way or another by Neurontin: http://factmed.com/study-GABAPENTIN-causing-MENTAL%20RETARDATION%20SEVERITY%20UNSPECIFIED.php

    I find all of these interesting. I have found many article that discuss the use of Neurontin for dementia (off label of course)… I wonder if there is an illness that Neurontin is NOT prescribed for?!

    Hugs,
    Angela

  25. Thanks for the info on the Neurontin. It does seem to help, but yes, it has a lot of side effects. The dementia thing you mentioned is worrisome… are there any studies on that? If so, I guess I won’t be taking that anymore…

    Come to think of it, no one asked me about the IV Benadryl. I asked *them* about what was in the IV after they had already given it to me.

    I guess I hadn’t even thought about the whole consent thing. I was in so much pain and could not speak normally and was very afraid that I was having a stroke; so, I was pretty much game for any relief at that point.

    Thanks again for the info! I plan to check out your book.

    Roz

  26. Dear Roz,

    Thanks for your comment and your question on Neurontin (Gabapentin) and also Benadryl. I will address both drugs.

    First let me address the less harmful but silly one: Benadryl. As a type I antihistamine, it blocks histamine release. The critical factors to know is that histamine is water modulator in the body so taking antihistamines dehydrate. The strongest antihistamine in this respect is Benadryl so the giving of Benadryl for migraine is following the “too much blood vessel swelling in the brain” idea, which is totally wrong. Also note: Benadryl in NOT FDA approved for migraine use! So you were a guinea pig.

    I am very much against off-label medicinal use and one day I will address it in a professional way. I bet they did not ask for your written consent in order to provide you with an experimental treatment! By law they must–but FDA permits off label use. If I were to run a clinical experiment like this, I would have to get ethical board permission and several signatures from you to conduct a trial… but in-hospital doctors or doctors in their offices are able to override this via the off-label permit. This is wrong and I will fight it!

    Now let me explain the more serious medicine: Neurontin (Gabapentin in generic). Gabapentin blocks the functions of your brain. It blocks both voltage gated sodium channels (the ones your brain needs to use for voltage generation) and also voltage gated calcium channels (the ones your brain needs to release neurotransmitters to make your brain function). This drug also prevents the creation of synapses. A synapse is the end-stage of your neurons’ work when the neuron releases a neurotransmitter (same as hormones only within the brain) and the neuron next to it picks it up. This is how the brain communicates. It is like a domino reaction: one neuron releases a particular neurotransmitter that is a “message” that another neuron picks up. If this particular message reaches many neurons, a “threshold” is reached and a particular command is sent by your brain to your brain and/or body to do something.

    Gabapentin prevents the formation of such synapses so your brain neither sends nor receives massages… your brain is not working.

    The goal is good: prevent the brain from creating high voltage (needed for the synapse) because high voltage can cause seizures (and migraines apparently, the mechanism is the same). The method is bad because 1) it is systemic so your entire brain is prevented from working. This includes automatic functions like temperature control and others. It even modifies how you blink. 2) The brain is extremely adaptive. This means that if it is not using something, it will destroy unneeded useless elements in the brain or it reassigns those resources to other tasks.

    Since the formation of synapses is a primary function of the brain, adaptation means retardation in children if they receive it prior to full brain formation (age 32 for women and 35 for men!) and it is a bullet train of high speed toward dementia for adults who receive it. It also affects your heart–your heart also works with voltage. It affects your entire body, including digestion since you are not able to release serotonin to help the intestines create the natural wave action to push the food through so you will likely be constipated. There are a lot of negative things that Neurontin causes.

    I so far have not meat anyone for whom it actually worked as intended.

    If you are taking Neurontin, please discuss with your doctor if there are alternatives that do not shut your brain down. I am sure there must be some conditions where such medicine is warranted–perhaps fibromyalgia in advanced stages when everything hurts and the choice of becoming demented to not having 24/7 major pain all over one’s body is a fair exchange. I cannot think of any other illness where this drug (and similar drugs that I call “drugs of shame”) have any purpose that is of benefit!

    I hope I was able to explain what this medicine is. As for migraine prevention, please read my book Fighting the Migraine Epidemic to understand how to prevent and treat migraines. Thousands of people are now migraine and medicine free as a result of my research on migraines. Good luck to you. Feel free to contact me. My email is in my book.

    Hugs,
    Angela

  27. You are the first person who has ever explained my classic (aura) migraines in a way that will really help me to help myself. I found over the years that consuming soup (lots of sodium) always seemed to ease the headache (if it wasn’t so severe that the nausea didn’t allow that). Now I know why! I use organic (no MSG, just salt). Amazing.

    I also never found any article that really explained how the “spreading cortical depression” worked. Thank you so much!! The concept of non-working neurons and the others trying to ‘wake it up’ in essence really helped me to understand.

    Recently, I received intravenous Benadryl at the ER for an extremely severe left-sided migraine caused by taking resveratrol (never again!!) How would Benadryl help a migraine? I know it hits a lot of receptors (blocks more than histamine)–what could it be doing that helps. The only other really effective drug for me is Neurontin. How does that affect the process of a migraine.

  28. Gwenyth I have a book titled “Fighting the Migraine Epidemic” that discusses the cause of the problem and how to tackle it. I also run a migraine group that focuses on the application of the book. The group is found here: https://www.facebook.com/groups/219182458276615/ if you have a Facebook account. If you prefer a more private approach, please contact me at Stanton Migraine Protocol website at http://stantonmigraineprotocol.com/ and fill in the “contact” form to start email discussion.

  29. Maren, estrogen does increase sodium in cells but that means very little in isolation. the questions is rater to understand why and how to handle that. One of the problems with menstrual cycle is that in the background the hormonal variations increase needed brain voltage to regulate and send messages about the changes to the body. This increased need for more neuronal firing necessitates increased voltage and which then necessitates increased amount of salt, water, potassium, calcium, magnesium, and phosphate increase to be able to allow the brain to function at a higher level. In other words, prior to a woman’s period, 3-5 days prior she needs to start to increase electrolyte increase and stop eating sugar so her electrolyte is less disrupted. This allows for more voltage and more efficient monthly cycles. I wrote about this on this website adn you find that article here: http://www.hormonesmatter.com/migraines-hormones-behind-curtain/

  30. Angela,

    Thanks for the clarification. I usually get migraines just before my period or sometimes mid cycle and I believe it is related to a drop in estrogen. I know that sodium deficiency also triggers my migraines, so I am trying to see if the drop in estrogen causes sodium deficiency. I found the following statement on another website: “Estrogen and most of the synthetic progestins increase intracellular sodium and water uptake. The effect of this is hypertension. Natural progesterone is a natural diuretic and prevents the cell’s uptake of sodium and water, thus preventing hypertension.” I am wondering whether at these times during my menstrual cycle, there could be an imbalance of estrogen and progesterone resulting in a drop in sodium concentration. Do you think this is possible?

  31. Hi Maren,

    Thanks for your response. Serotonin actually has very little to do with it. I know they give serotonin medicines thinking that it is the lack of serotonin that causes migraines but in fact the cause is what causes the lack of serotonin the first place. Resent research shows that the brain regions that do not have enough energy go dormant (called cortical depression or CD) and thus these CD regions are not able to produce anything. If that region happens to be serotonin making region, serotonin drugs will help. If that region is responsible for some other neurotransmitter and not serotonin, you will not get relief from a serotonin drug. Only about 30% of migraines respond to serotonin drugs but for the same person not twice will necessarily the same serotonin drug work since regions that go into CD mode change.

    Electrolyte disturbance is caused by carbohydrates that convert to glucose. Glucose kicks sodium and water out and it holds onto water outside of the cell. This is the cause of electrolyte disturbance and it is very far from serotonin.

    Electricity in the brain (and in the heart) for action potential is created by salt. Salt breaks up to positive and negative ions of Na+ and Cl- and the voltage differential of these ions creates action potential. Reduced salt in diets coupled with increased sugar consumed is responsible for the migraine pain.

    Migraine is actually a bad name since it represents a disease but latest studies show that migraine is not a disease but is in fact a symptoms of a special brain that has more sensory neuron receptor connections than a regular brain. More sensory receptor connections imply enhanced sensory organs, which all migraineurs seems to have. But more sensory receptor connections also require more energy and thus more electricity and not less.

    Reduced salt diets hurt the brain of those with more sensory neuron receptor connections. Diets rich in simple carbs such as sugar, soft drinks, sweets all disrupt electrolyte and reduce sodium level so electricity is harder to generate. That is why when you ate salt your migraines eased. It has little to do with serotonin.

    By the way serotonin releases together with insulin. So every time you take serotonin medications your insulin also releases, predisposing you to diabetes. There are many articles on the connection of migraine and metabolic syndrome but they all seem to not see the connection… Serotonin and glucose sensitivity as a result of electrolyte disruption is the connection.

    I hope this helps you in your migraine treatment.
    Angela

  32. Angela,

    I’m so glad I found your post. I’ve long suspected that a drop in electrolyte concentration could be the reason for my migraines. My first indication was that one of my migraines got noticeably better after I ate some pretzels. I suspected that the salt was the reason. (Recently, I read that a high carb meal might enhance serotonin availability in the brain, but I did not know it then.) so when I had a migraine on a transatlantic flight (I always get migraines on long flights and know now that the air on airplanes is very dry and causes dehydration by exhalation.), I ate some salt packages and after every package, the migraine got better for a while. I am puzzled as to why some websites say you should drink lots of water. Once I was out in the sun on a hot day and got one of the worst migraines of my life even though I drank lots of water. Now, I drink an isotonic sodium and potassium containing solution when I do sport. I hope it helps. Would you know why I get migraines when my estrogen level drops? Do you think it is also related to electrolytes or might it be a different trigger mechanism?

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