Elena Gross
About 3 million people a year are diagnosed with Migraine Headaches. Re-occurrences can last for years and for some Migraines are a lifelong struggle. Migraines are debilitating, robbing the joy from life. Most sufferers live with anxiety awaiting the next episode. Symptoms can range from pain in the head, neck and face to auras, tunnel vision, spontaneous vomiting and unconsciousness. There are no lab tests for Migraines and brain imaging is little resource. Many of the drugs used to treat Migraines don’t provide much relief and come with hefty risks. Most are anti-psychotics or drugs used to treat nerve pain. There is emerging evidence that there may be a metabolic component to Migraines that can be influenced by diet and lifestyle. Imagine that. Many of Migraine sufferers are already experiencing near complete remission. Your physician isn’t talking to you about this. But you’ll hear all about it on today’s show.
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[00:00:00] Hey, hey, welcome back to another episode of superhuman radio. It's Monday and you know what? I'm starting to launch every week with a fantastic show a show that actually helps people and today is one of those shows in just a moment. I'm going to be joined by my [00:01:00] guest Elena gross to talk about.
[00:01:03] Getting rid of migraine headaches. Is it possible why wouldn't my doctor told me about it? Because your doctor doesn't understand the etiology the true ideology of some of these disorders and that they have a metabolic component and let's be honest. We know the doctors really don't know anything about nutrition and it's an important discussion and I'll tell you why.
[00:01:25] Three million people a year are diagnosed with migraines and quite often. They they fight with them for their entire lives their debilitating there. So severe that they can rob the Joy from your life. Not just when you experience them about the anxiety of will I have one today people with migraines tell me and I did a post about this asking people that suffer from migraines and I got PMS, you know, I'm afraid to go.
[00:01:53] Disney World with my son because I'm afraid I'll get a migraine while I'm there. [00:02:00] I mean think about the restrictions on life that this can cause for you and 3 million new cases a year are diagnosed and the drugs that they typically used to treat them with antipsychotic drugs and drugs like Neurontin which has severe side effects.
[00:02:20] They give those to people with neuropathies and stuff like that. So obviously that's not what this show is about. The show is not about prescribing drugs. This show is about finding the causes of problems and making them better and my guest Elena grows. How you doing Elena? Oh, hello. There. You are.
[00:02:43] I'm here. Thank you so much for having me. Yes. Yes. Now you are where you're where are you right now? I'm in Basel Switzerland. Yeah, you're in Switzerland. Yeah, so thank you so much for being here with us. Yes, and I met you several years ago a Dominic D'Agostino's lab in Florida. [00:03:00] Exactly. He's my external supervisor since we're doing a clinical trial on the potential preventative properties of exogenous ketones in migraine.
[00:03:11] So, I'm very honored that he's onboard and Advising. How to do it properly so let's talk about this. Where did your journey with an interest in migraines come from? So I was a Oh, I still a migraine patient. I suppose when I was about 14 or 15. I used to get these strange headaches one-sided and they came with a lot of nausea and light sensitivity noise sensitivity and sometimes even smell sensitivity and were preceded and buy a lot of fatigue and tiredness and I used to go to from one doctor to the other and everybody.
[00:03:45] I thought it was maybe psychological and talk about it took them about a year to figure out what was going on. And I then learned it was migraine headaches and it was not so bad when it started. But over the years it used to get worse and worse [00:04:00] until after I finished my bachelor degrees. They have had become chronic and chronic meaning about 20 days of migraines per month.
[00:04:08] So I really wasn't going to get a normal job anyway, so I decided I might just go into neuroscience. Potentially within my life span figure out more about what is causing a migraine or how could be potentially better treated because as you said very nicely all the pharmacological agents are for Ocho mostly bought from other diseases like depression or epilepsy and nothing was really working.
[00:04:33] And so I went into neuroscience and did to master projects on migraines and towards the end of the degree. I stumbled across the eldest treatment for epilepsy, which your listeners probably know is there. Jenny died or a fasting mimicking died. And when I read upon the mechanisms, I realized that this must be migrant relevance and this explain some of the information which some of the things I've been struggling with before.
[00:04:57] Okay. I you you've said it several things that I [00:05:00] want to stop and talk about first. So first of all, think about this the the audience that has never suffered a migraine Elena decided she's never going to be able to work. In a normal setting anyway, this is what migraine sufferers live with they literally have to change their lives because they have migraines number one number two.
[00:05:24] you said something that I want to stop and and focus on the importance of a lot of people think that the ketogenic diet is pounding down tons and tons of fatty foods and avoiding protein and carbohydrates, but you said a ketogenic. And a fasting mimicking diet which both we have to assume that the the patient or the user is in some sort of calorie deficit or they don't work.
[00:05:51] Is that an accurate statement? It depends. Well what they try to do a hundred and fifty years ago, I would say is they try to look at [00:06:00] what are the characteristics of fasting that we can mimic in a diet as in how much fat is burnt protein or carbs when you are starving? And the body is not really noticing or it to some extent some of the mechanisms still work if that dietary fat comes from outside and you're not burning your muscles or broken organelles and get your protein from that and they figured out a ratio and this is the earliest ketogenic diet really was about.
[00:06:29] 75 to 80% fat 15% protein and 5% carbohydrates and when it was used for epilepsy in the Clinic's today, it depends on the strength of or the severity of epilepsy. It's really rather strict. So it's 4 to 1 ratio meaning that for parts or three to four parts of your calories come from fat only and then it's one or two parts that are carbohydrate and protein mix and we know that for a not severely affected epilepsy or migraine patient.
[00:06:58] This is probably not necessary. It's [00:07:00] probably not advised. I mean you have to watch out if it's kids or if it's patients that are very lean that they not in a calorie deficit all the time because otherwise they'll just waste away and they won't grow but if you're looking at a say a chronic migraine patient, who is a little bit old bees or overweight or yeah, it's not not that that lien or skinny then I agree.
[00:07:22] You probably get the best benefits when you're in a bit of a color except. I don't mean the extreme. Calorie deficit but some calorie we saw this in cancer. Also, we know that a lot of the people who want ketogenic diets to manage certain types of cancers. They didn't see the benefits until they were in a slight calorie deficit.
[00:07:43] So I thought I would go even even further I would probably say it quite significant keto deficit as opposed to us a epilepsy or migraine. Okay? Now there's something else something else about my about migraines interests me, and it's [00:08:00] okay. So when we when we look at the Spectrum of brain issues from psychoses to migraine headaches to seizures.
[00:08:14] We see an onset of these disorders right around the time. As of the onset of puberty what role does a sex hormones play in the etiology of migraine headaches? and that's a very interesting question and I don't think we have the full answer to that question yet, but I can say that before puberty actually migraine frequency is very similar in boys and.
[00:08:42] And when puberty hits as you say this ratio turns more towards the female side. It's about the three to one ratio. And also there's something called menstrual migraines we can observe that just prior to the period onset or menstruation migraine frequency Rises a lot. So a lot [00:09:00] of girls women get more migraines or Mom or migraine prone when these estrogen levels dropped before the period starts and one of the reasons is probably that estrogen.
[00:09:11] Health is very antioxidant. So you can have some some protection from oxidative stress or energy deficit when those levels are high and when they drop in the female cycle you with the brain just becomes much more vulnerable and I think that these cycling hormonal changes that you have in a girl and not so much in a boy could contribute and then we also have another issue that is often not very much talked about and that's sort of oral contraception.
[00:09:40] Researches phone actually that when girls start a pill after about a year oxidative stress and that's is free radicals. You might have heard of increases by up to 50% on average and that's. So if you think about migraines being and I think that's true at least for part of it and [00:10:00] energy deficit syndrome of the brain and maybe we have time to elaborate this a little bit further later on increased oxidative stress stress seems to play a huge role in migraine.
[00:10:10] And now you're giving these young girls in their puberty and oral contraception like candy basically and there have their oxidative stress levels increased by 50% and that's inhibits the mitochondria which are the. Energy-producing powerhouses of the cells and so you have less energy and then an energy deficit in the brain is becomes more and more likely.
[00:10:32] So the one other thing I'd like to submit humbly submit is that estradiol specifically is also a powerful anti-inflammatory exactly. I remember reading a study about 15 years ago that. When when individuals receive blunt force trauma to the brain, there is aromatisse enzyme in the brain that spontaneously starts to aromatize [00:11:00] androgens instant estradiol.
[00:11:01] There's a receptor on the cell and I believe it stands for fibroblast Activation factor F AF but when estradiol docs in this cell, it completely shuts off. Information to help stop the brain from swelling. So I would imagine that there's an anti-inflammatory Interruption as well during that period of the menstrual menstrual cycle as well as the use of these oral contraceptives which are usually progestins and they shut off estrogen.
[00:11:32] Exactly. So that's yeah, well done and inflammation inflammation plays a role in migraine also, at least that was that's what studies suggest animal research and I think you're right oxidative stress and inflammation really go hand-in-hand and estrogen estradiol is really counteracting those negative effects, and that's so interesting and you know, and and for me, that's the first thing that a doctor should be [00:12:00] saying.
[00:12:00] Well, wait a minute. Why are we? Well, okay, I don't want to get off on a tangent. So anyway now do migraine headaches always include pain can someone just because I know a girl that right around the time that she started to get a period she used to get auras. You know, she would see Halos of light around things, but she didn't have any subsequent pain.
[00:12:24] Is that a migraine or is that something different? That's also my great, and maybe it's just worse summarizing. What a typical migrant is for those that aren't please please. Relatives. So compare definition a migraine usually is a moderate to severe headache that is typically one-sided and lasts between four hours and three days as in one attack and it comes with Associated symptoms such as nausea fatigue tiredness it gets worse when you move and then you have these sensitivities to light noise.
[00:12:56] Smell even and yeah, and and [00:13:00] also you assert of the suffers get what you just mentioned the so-called Aura phenomena, which is basically can be visual but also motor dysfunction. 30 minutes prior to the to the headache face, but the headache face really is just one phase of the migraine. There's four faces one is the pre monetary phase where you get dizzy or tired or weak and you can feel that the migrant is coming then a third of the patients get this Aura face, then comes the headache face and then the poster on phase and I believe that all of these distinct phases can happen on their own.
[00:13:34] So they're not they don't need to happen together. I think there's even patients that only have the premonitory face. So this extreme fatigue and it isn't always followed by the headache and you can have orders isolated also. Wow, that's so so did these can happen individually to people with so theoretically you could have just the aura but not the pain that's amazing to me.
[00:13:56] Exactly, and maybe it's also worth saying that [00:14:00] migraines are probably more related to some phones forms of epilepsy than they are to tension type headache that a lot of people experience when they're stressed or yeah or have muscular tension in the neck. Yeah, and it's and it's a very good trojainous disease.
[00:14:14] That's also important. So even though the phenotype so what it looks like in patients might be similar. There's a lot of different genetic variations and mechanism sets are playing different. And if I may just say that around the world about a billion people suffer from migraines. So that's 50 percent of the population and migrant susceptibility is determined by genetic factors.
[00:14:39] And that's why it's subject to forces of natural selection. Now if something is that prone it must have had a reproductive or a survival Advantage at some. So I think that there's a this is a strong argument that our environment has become inadequate or suboptimal for the genetic migraine [00:15:00] compositions.
[00:15:01] And one of the factors that has drastically changed within the last ten Thousand Years is as we all know nutrition. Yeah do the Agricultural Revolution one Mark nutrient is now constantly available and that's carbohydrates. And if you have somebody who's not that's well adapted to that kind of metabolism.
[00:15:18] The brain is more likely to run into. Energy deficit and a migraine could be an Adaptive response. And this is also with all the biochemical changes have happened that basically forces you to restore energy metabolism or conserve energy and to any energy homeostasis in the brain that has been yeah we so so we do know that disorders like Parkinson's disease and some other neurological disorders.
[00:15:50] I have a what is now known as insulin resistance of the brain component. Do we see do we see [00:16:00] a higher occurrence in people who have pre-diabetes or diabetes and insulin resistance Frank insulin resistance and and the linkage to migraines. That's a very interesting question. I was hoping you were going to go there at some point.
[00:16:16] Interestingly in migraine diabetes is migrant protective. So the migrant product Providence goes down in diabetic individuals. And why is that so let's look again at The evolutionary perspective of insulin resistance, right insulin resistant actually was fat cunt 10,000 years ago and evolutionary Advantage.
[00:16:37] Why is that when you were. Starving or when carbohydrates are not readily available. You have to leave some of the glucose for tissues that were not able to burn proteins or fatty acids. So well and one of those organs is the brain so insulin resistance refers usually to the muscular tissue becoming resistant to insulin, so it doesn't take as much [00:17:00] glucose in the doors don't open as widely, even though insulin is present and your brain could.
[00:17:05] The energy needs the glucose it needs to for you to survive and we find insulin resistance in another very common phenomenon. That is pregnant women gestational insulin resistance is probably evolutionary a similar process where the mother turns insulin resistant so that the baby gets the glucose that is available.
[00:17:25] Oh, wow, that is so interesting. I never thought about that that makes so much, you know, and I'm just I'm like you Elena. I look at everything through from an evolutionary perspective and you can figure things out and I that's brilliant. That's brilliant. So now back to the migraine it is not a consistent correlation between insulin resistant and my grandson find it some don't and I think migrant insulin resistance in the migraine body is an Adaptive response to the energy deficit in the brain.
[00:17:55] So the brain notices, oh my God, we don't have enough energy. We now [00:18:00] need to turn muscles insulin resistance so that the glucose can get inside. And so I think in a sense of a migrant where we see more like hypoglycemia and not type of like here so glucose levels tend to be lower than in the average person.
[00:18:13] We probably have insulin resistance as an Adaptive response rather than being part of the problem and then I can decide if I may tell about very early studies that are very interesting. I'm not sure if it's if it's the time it's about no no, go ahead good. We'll wait for the break to this good too.
[00:18:32] Okay, fantastic. So basically a hundred years already and this research has been largely forgotten or not looked upon any more migrants have been referred to the hyperglycemic headache 1935 and around that time a little bit later doctors have tried to assess glucose metabolism in migraine and given migrants between fifty and a hundred grams of pure glucose glucose on an empty stomach and this is called a glucose tolerance test.
[00:18:58] It's also used in diabetes. [00:19:00] And actually those researchers were able to trigger a migraine in about 50% of the patients just by giving glucose on an empty stomach. And there's other observations that are found all they looked at. What is the difference between how do patients differently respond to those?
[00:19:16] Who calls those that get a migraine and those didn't get a migraine and I think this is going to be very interesting to you. Also in those patients that develop the migraine after glucose or glucose. He Tony Genesis was turned on cortisol was turned on and lipolysis was turned. So it's almost like in these patients that got migraines after glucose.
[00:19:38] The brain was noticing. Oh my God, we're now hypoglycemic. We don't get enough sugar in here. Let's start putting on a difference metabolism route. Let's let's turn on lipolysis and produce Ketone bodies. So that energy homeostasis Cameron restored, right? That's amazing. Now. That's a good. I'm sorry.
[00:19:59] I didn't mean to interrupt you. [00:20:00] That's fine. No, I thought that's it. Basically, but now I only wanted to say that was Modern painkillers and pharmacological agents. What we do is when the migraine comes we take a triptan, we take a potent painkiller and then we start moving about and eating normally again, and this ketogenesis will just be turned off right at the beginning and then we just have a prolonged attack or we just evolved the next migraine attack because we stopped at natural pose.
[00:20:26] Yeah, because because first of all, I don't want to go too far into this because I have other questions, but I know that NSAIDs and stuff like that seemed not to work. I don't even know why people take them to help them migraines. But okay. So with what dangerous combination of triptan sometimes so acutely but you're only allowed to take those and take maximum 10 days a month.
[00:20:47] In addition to those migrants specific painkillers the triptans if you combine those it's quite a good action because the enzymes are anti-inflammatory, but the problem there is you get addicted or you get medication [00:21:00] overuse headache if you take them too often. So yeah, so now the next question has to be asked what about menopause?
[00:21:08] How does that affect a lifelong woman a woman life who has lifelong migraines because interestingly enough. A lot of the symptoms the bothersome symptoms of menopause hot flashes night sweats Tremor are associated with episodes of hypoglycemia because estrogen and progesterone play a tug-of-war in an effort to help manage blood sugar and as estrogen starts to fade away and progesterone wins.
[00:21:40] We see women who become very hypoglycemic. Very easily I spontaneously and so what happens to a woman who's suffered from migraines and second question do some women develop migraines post menopause. Okay, so that's an interesting [00:22:00] question and to answer this. Maybe I would love to go a little bit earlier and that is pregnancy because okay.
[00:22:05] Okay. Hold on hold on. Hold on there. Let's do this. Let's take this quick commercial break. When we come back, we'll doubt. We'll go down this deep Rabbit Hole of pregnancy and post menopause. Okay, perfect. So let's take a quick commercial break. Do you want to plug you? You have a website Elena?
[00:22:23] Do I have a website? Yeah, and I only have Facebook Twitter and these social networks. I don't actually have a website just yet, but I'm working on how do you want people to interact with you that are listening to Today's Show. I think Twitter will be perfect. Also Facebook. I'm usually reach their people reach out and YouTube.
[00:22:43] I have a YouTube channel. That's probably also a good idea to reach out to me there. Let's go. How do they find you on Twitter? How do they find you on YouTube? On Twitter I Melena see grows in one on on YouTube. It's Eleanor grows just like that. Okay and same on Facebook and [00:23:00] Elena is ele and a right.
[00:23:02] Exactly open G Ro SS right? All right, we're gonna take a quick commercial break. We'll be right back more of this. Hopefully we're going to help some people today stay tuned. Welcome back were talking with Elena gross were talking about how to manage and get rid of your migraine headaches. We're going to talk about that in a little bit later the show.
[00:23:20] We're still talking about the people who suffer from them and what they encounter so you can listen and figure out where you fit in this discussion, so, I asked about menopause and post menopause. And you said well, we have to talk about pregnancy. So let's do that. Let's talk about that. Okay, great.
[00:23:37] So I guess the first. Time in a life of a migraine or future migraine patient Mike and free energy changes is is when they hit puberty so we've talked about this and also the use of the oral contraceptive pill the next time my migraine frequency in a migrant pinch patient ends to improve or change drastically is a pregnancy, [00:24:00] especially in the second and third trimester something happens estrogen levels go way up and usually migrant frequency really plummets and that stays.
[00:24:09] In the also through through feeding the baby so lacked the whole lactate lactating periods. And one of the things that also happens during that time, very interesting me is that mothers tend to be in ketosis or they get easier into ketosis and the mother's milk. Some people might also know has a lot of mctv's.
[00:24:30] So we have some things that are very migrant protective which is the high estrogen and the increase teacher Genesis. So and another thing also that happens during pregnancy. Is that insulin resistance in some patients? So that also gives the mothers sprain more energy more glucose available, right?
[00:24:47] So this is the first time a migrant frequency range. Okay, let me come to menopause and post menopause. This is something I'm not an expert about I have to admit but what I [00:25:00] see is that or what is known is that Myron frequency plummets then a second time. So what we have now is estrogen is going is going down, but we don't have a fluctuation in hormones anymore.
[00:25:12] So the female cycle more looks like a more stable like I'm a cycle now and what does happen though is as at least I have heard that the females get menopause women get more insulin resistance more more easily write their group populism doesn't work as well. Diabetes is a risk factor in and even obesity.
[00:25:35] And if we look at our theory that says that migraine is an energy deficit syndrome of the brain. Then we know that insulin resistance diabetes and obesity is probably going to be migrant protective instead of migraine causing. Now, you mentioned hypoglycemia being more frequent in postmenopausal.
[00:25:54] Yes. Well not not not in post menopause as women are transitioning when they're [00:26:00] perimenopausal women. This is. They haven't really stopped producing estrogen but it's becoming erratic their their periods. They start to be a mentor react. They have one period is three months apart one is heavy one doesn't show up at all.
[00:26:18] So the changes are happening. That's when they experience this radical difficulty in managing blood sugar. Yeah, and I think this would also be the period where the mic on frequency goes up again before then plummets when you were. When you're through this period right and we can talk later about what can be done or what can be done to help potentially.
[00:26:39] Well and I so I just just observe for 13 years of doing the show and observing and talking with fans of the show. I can tell you that the women who have the most difficult time with post menopause that aren't on HRT because the women will go on HRT. They don't notice any changes, but the women who [00:27:00] don't go on HRT.
[00:27:01] They tend to be either very very lean because remember body fat produces estradiol through aromatization. So very very heavy women. They sometimes don't even notice that they're going through menopause. But also I noticed that women who have very strict and have had very strict low carbohydrate diet the long periods of time preceding menopause go through menopause.
[00:27:31] And come out of menopause much easier because I believe that dietary protocol keeps them from having these wild glucose wings. That's just what I've observed. I don't have any, you know, scientific research prove what I'm saying? That's super interesting and I think what you say makes total sense, I would also I mean the died you propose is very anti-inflammatory antioxidant.
[00:27:56] So all of these stresses are can. Make your [00:28:00] your life even harder during that time. I probably help with fire by the dietary change. Okay, so as we segue into the discussion about metabolic metabolic sand and and diet in the role of managing migraines, I have to say that I read a study many years ago that looked at the three macronutrients, you know of protein fat and.
[00:28:25] From it was one of those metabolomics studies and what they what the study determined was of the three. Food macronutrients that we eat on a regular basis only carbohydrates and the more refined the greater the effect only carbohydrates were pro-inflammatory. So earlier we were talking about migraine.
[00:28:49] Talk about oxidative stress. We're talking about inflammation and and the linkage between these and I can tell you I just had surgery on my foot. If [00:29:00] I eat a lot of carbs one day the pain in my foot is so much worse than if I go low carb and so there really is something to this notion. I am not an anti carb guy.
[00:29:11] I'm not telling people. Oh don't eat carbs because I think vegetables and stuff like that are good. But I think that the further you get away from a complex carbohydrates that have a very very low glycemic index and low glycemic load the higher your inflammation in your body goes and we know this because when people go on ketogenic diets, they go.
[00:29:32] Oh I lost six pounds in the first three days. Yeah, but that's water weight. Yeah, you're right. Well water weight is edema. The reason your body is holding water. Easy because it likes water it's because edema attracts fluid from the body and the more edema. You have the more fluid you're going to have in your body.
[00:29:51] Am I off base on that?
[00:29:55] Would you agree with that Elena? Well, so when you when you lose [00:30:00] glycogen in that period glycogen also holds water but glycogen by a total liver glycogen and total muscle glycogen even. Those of us who are hyper muscular is is measured in thousands of grams. I mean, it's not a lot. It's not nearly as much as the fluid people lose when they start a low-carbohydrate diet and my humble opinion now, you know, you know better you're a scientist.
[00:30:24] I don't it's just my observation. Yes, certainly. I was probably always a mixture of an attack grades. You have the loss of glycogen you have the loss of some minerals then you lose some water and the information goes down certainly and that probably also leads to or certainly leads to less edema.
[00:30:40] And yeah, I'm with you on that. So let's talk about what you have discovered in the lab what you have worked on what you have found Let's help people now, we've laid out pretty much everything we can. About the the the the whole situation with migraines. How do you manage it [00:31:00] dietary? Okay, so that's something we haven't assessed in the lab like formally so we haven't tried one thing with one group of patients and another thing with the other group of patients.
[00:31:12] So basically I can talk about the findings that I can get from literature and I can I can find the observations that I have from seeing patients in the study and from from what they say and what I have experienced and what I have advised other patients may be as were saying that I'm not a medical doctor.
[00:31:30] So anything I'm going to say here is for informational purposes only research scientists. But yeah, since we know maybe we need to go back and say there's mitochondrial dysfunction in the migraine patient, meaning their mitochondria. Probably not working as well as the mitochondria of other people.
[00:31:47] So that has genetic predisposition that has a genetic background. We also have a very hyper excitable or hyper responsive brain meaning that a migraine. Brain doesn't [00:32:00] habituate you say so if a migraine patient looks at a checkerboard. The brain usually includes only for change so it would stop firing at some point to conserve energy.
[00:32:10] Hmm a my patients brain will still fire all the time. So that means that also explains to some extent that light and noise sensitivity. So a migraine brain is just burning more energy because it's just so much more active all the time and then we have the maybe also genetically determines inflammatory markers that tend to be increased we have less antioxidant capacity.
[00:32:33] I've been patient. So that means whenever there's a mismatch between the oxidative stress that we get and the antioxidant capacity of the body to basically neutralize that oxidative stress whenever that is mismatched that can be dangerous and that's going to be happening in the migraine patient.
[00:32:50] And and we also know from genetic studies that energy metabolism in general can be. Can be malfunctioning so glucose metabolism glucose [00:33:00] transport crude one Transporters and there's an association between so much hundred diseases more classically and migraine a lot of these have migraine and if you look at trigger factors, they also are all stressed Fleet changes hormonal changes sensory triggers weather changes, even they can all be associated with oxidative stress now.
[00:33:21] I just wanted to give that before I now say what what can be done to address. See specific problems. Maybe it's also worth mentioning that we have or some research has found glucagon sensitivity or reduced glucagon sensitivity in the migraine patient glucagon is the opposite of insulin and basically in a fasted State glucagon is a hormone that signals.
[00:33:43] Okay, we need to do gluconeogenesis. We need to produce key John's now because when an energy deficit. Similar to insulin resistant when you in when you are insensitive to glucagon resistant, then you will not produce as much energy in a fasted state. So this could also explain some of the hype of [00:34:00] leukemia in a migraine patients and then we have this reactive hypoglycemia.
[00:34:05] We've talked about so kind of a glucose intolerance and we can actually measure with neuroimaging that says reduced ATP even between attacks in the migraine brain by as much as 20%. So you can see that a migraine self has 20% less ATP on average to work with on a constant basis. So that's quite massive.
[00:34:27] And yeah, so what can be done one of the cubes treatments that are used in the clinics for a status micro gnosis. I think it's called when you have a migraine attack that doesn't go away is actually cortisol. So they give hydrocortisone. Ivete intravenously and that we know is turning on gluconeogenesis and hegemony Genesis.
[00:34:47] So maybe that works Wyatt via giving the brain more energy. Then we have caffeine is sometimes use caffeine is is also stimulating cortisol and works. Probably quite quite similarly [00:35:00] for prophylactic treatments. The first the first thing one can do is if the mitochondria are not working properly, it's important that they get the nutrients they need.
[00:35:09] To work properly so that could be magnesium riboflavin coenzyme Q10 antioxidants like alpha lipoic acid B vitamins and also be tied Roxy great. One of the Ketone bodies have has been shown to have antioxidant properties. That's that's like the first step the Second Step. I would propose is the reduction of oxidative stress and increase of more antioxidants and this can be perfectly done with with diet.
[00:35:35] So eat real food. Limit your processed foods hide like eating Foods. Glucose in general in more leafy and colorful vegetables potentially and then thirdly I think you want to stabilize blood glucose and you already touched upon this. So again if you eat a lot of glucose or process. Sweet foods are they will [00:36:00] increase your glucose and your or especially your glucose fluctuations and that increases inflammation again and oxidative stress and will also lead to hypoglycemia in the brain in the long run.
[00:36:11] So with a low carb or even ketogenic diet low GI foods and Whole Foods sentence and forth. If you're very severely affected patient, you might have to offer the brain and Alternative Energy substrates. In addition to glucose and that will now be Ketone bodies. So if you have compromised glucose utilization or transport, this is where you need to be strict with your carbohydrates moderate with your protein, maybe sometimes even restrict calories so that you get into ketosis and if you have problems with that.
[00:36:44] Sometimes maybe even a good Ketone body salt might be or exoticness Ketone Body Source might be indicated in that though. That's a little bit controversial. So the force would be a ketogenic diet at least secure clean to give the brave. [00:37:00] Why is it? Why is that? Why is that a little controversial? I mean doctors give patients drugs.
[00:37:05] Why would telling someone to use a ketone salt or even now becoming more and more popular yet? Highly expensive. There's quite a few Ketone Esters out there that can be taken in very very low doses. Why is that controversial now with the Esters one one doctor friend has told me he's used his for epilepsy for severely affect the patient and he seen some liver toxicity because of the butanediol.
[00:37:29] I haven't done that study myself. So with the Esters, I'm a little bit careful just because it's not an endogenous molecule. It's not in natural. It's a it's an artificial molecule that in some patients may be we don't know what it does in the long term. I just don't know. I think that the salt especially the Diesels in long term should be fine.
[00:37:50] They should be healthy and you say is always a trade-off between yeah between benefits and costs. Right? Right, if the benefit outweighs the cost of [00:38:00] potential long-term problems of some sort in 10 years of taking but you've had a wonderful life until then and you can pain-free and whatever I think that's a valid risk to take me personally.
[00:38:10] I've even taken the racemic Sol's for two years. I'm taking the defaults now well-formulated Dussault combination and we're testing it in the clinic. So we haven't had any safety concerns even with the racemic salt. So the patients have been taking it for 3 months at a time. I'm only saying this because there's some people out there that think it's very controversial and I'm a little bit careful with the Esters when it comes to patients, but.
[00:38:35] The salts. Yes. I mean for me it's a fantastic tool to for somebody who is glucagon resistance and can't really make many Ketone bodies or somebody who's struggling and wants to eat a bit more vegetables. I think it's a perfect tool to use if you have a high quality salt and maybe even an ester once that's safety data is out there to increase your life.
[00:38:59] How do you say [00:39:00] your quality of life? Right exactly? I'm actually I'm actually texting someone right now because she has terrible migraines and I'm telling her about the ketone. So it's you know, it's amazing on his anecdotes several patients that have used it that have dropped the migrant frequency up to 80% So on average I'll pilot data is actually 50% reduction within one month not changing the diet, which is nothing I'd ever proposed.
[00:39:28] But this was just eating a carbohydrate which died only supplementing the. And my green reduction of 50% in a month that's quite unheard of with pharmacological agents even so yeah. I'm I'm definitely Pro, but I know that more research is needed to advise it to patient population in the long run.
[00:39:50] So I'm a little bit careful so chuffed up baby from so many patients that. Before we go into this next commercial break. So tell me again your [00:40:00] personal experience. So you were having 20 migraines out of 30 days and 20 migraines over the course of 30 days on average and now since you've been using the Ketone salts and you've changed your diet obviously to a low carbohydrate diet, so you lower inflammation lower oxidative stress.
[00:40:20] And you're doing some of these other things, you know, supplementing perhaps with antioxidants good antioxidant products. And so what what are you what are your occurrences of migraines now? About three days a month. So yeah, that's very easily manageable with even only painkillers. I don't even need to triptans anymore.
[00:40:38] So it's been a trusted Improvement and the interesting thing is I've only been in ketosis and taking these things for about two-and-a-half to three years. And after that I think does. Positive gene expression changes their outlasting the actual ketosis. So now in low carb diet or a low paleo diet even is fine for me and I'm keeping the [00:41:00] benefits.
[00:41:00] Yeah, we see we see this. So we see the same phenomenon in people with seizures and epilepsy who will put on a ketogenic a strict ketogenic four-to-one ketogenic diet. They're put on it just for a couple years and then they take them off of it and their epilepsy goes away and this is especially true.
[00:41:17] In the younger more plastic brain we see but we know that neuroplasticity last your lifetime so it can happen for older people to yeah, you're well-informed. We for a long time thought this is just because they're kids and they're so plastic. But even in the epilepsy adults that are using this trick huge any guide for two to five years.
[00:41:38] It seems to be exactly the same. So I think that's fascinating and it might be similar in my great actually. Okay. So now. You tell me the truth. Now when you do have the their migraines now, do you look back the day before and think oh I shouldn't have eaten that or you look at things in your life and think I'll I can I can see why I'm having one today.
[00:42:00] [00:42:00] Yeah, so it's my alcohol is a trigger still I have to say so if I'm yeah, if I have two glasses of wine instead of one which can be my limit kind of I would still get an attack and then I have to admit that. I've also been heavy metal. I had or still have to some extent heavy metal poisoning, which I'm where were you have what you have what?
[00:42:20] Heavy metal poisoning. Oh Ned LED Mercury, which a lot of it came out of the fish and some Vector not vaccinations, but he's in Civilization. Yeah vaccines I have been getting and I have bad liver detox genetic variance or my liver. Detox. Pathways are compromised. So. That causes a lot of heavy metals cause a lot of oxidative stress.
[00:42:45] So when I stopped the medication that I'm using these chelating agents then a migraine usually comes after but that's to be expected. So, I think once the heavy metals are out, I might be migrant free actually that's exciting. That's [00:43:00] it. Now do you do do you do any do you do any therapeutic phlebotomy?
[00:43:06] I'm not sure. I know what to say. Okay, so so I recently discovered that I have iron overload and instead of taking a chelation product to try to chelate the iron out of my body. I just donate blood and then I haven't so do you do donate blood from time to time? I'm not allowed to because my blood literally is so full of heavy metals that it wouldn't be wrong, but wait a minute.
[00:43:34] Okay, so that's different. So I actually go to a center. They know that I have high iron. I have high amount hematocrit. I can't go down at donate blood as a rule at the Red Cross but my doctor writes a prescription for them so I can donate blood once every month once every couple months and they just throw my blood away.
[00:43:53] They don't use it for anything. It's just to get it out of my body. Yeah, that's good. It's good for iron other heavy metals [00:44:00] tend to accumulate intracellularly and in the brain, so it's you have to take a chelating agent that actually takes it out of the cells. So I think donating blood. Probably wouldn't solve the issue but it's something at the beginning I should could have or should have done but now my blood is is much better Russia selling face is almost clear.
[00:44:22] It's now with intracellularly and I'm taking chelating agents that can take it out and I've improved so much over the last year. It was really bad the beginning of 2009 t18 and and now this year's is so much better and I think it won't take too much longer to be back to normal. And this is something one can one probably needs to take care of in a ketogenic diet if you're not so sure how good your detox genetics is so that was my mistake.
[00:44:48] I didn't know that heavy metals are in fish, especially tuna fish and and and organ Meats especially so I've been eating a lot of those and not always organic. And and even green leafy [00:45:00] vegetables tend to accumulate company or more than other vegetables. So if you if you want to be careful, I would probably go for organic meats and and limit fish intake until you know, whether your detox genes are affected or not.
[00:45:16] Yeah. I just I had 23andMe and I have good detox Pathways. I also have longevity genes, and I don't have any of the markers for Alzheimer's disease. Perfect. Could it be you? Yeah, I'm lucky. I'm lucky. I got lucky. I want to take our last commercial break and when we come back, I want to talk about diet from a different angle stay tuned.
[00:45:33] We'll be right back when talking with Elena gross. I just subscribe to her Twitter feed and her YouTube channel on Twitter. She's Elena ele NAC gross G Ro SS and then just search for Elena gross on YouTube and you'll find her. There was one question. I just realized I forgot to ask you when a person is in.
[00:45:55] A migraine do Ketone salts [00:46:00] help acutely. Like if it's somewhat little to help shorten the duration of the. Yeah, that's a brilliant question. I think that you have to catch the migraine really really early for that to help because think about it as stone that is going to run down a mountain, right if you catch that stone very early on it doesn't do much to stop it.
[00:46:23] But once it kept once it's going it's it has a lot of seat. It's really hard to actually hold it home. Hold it right and I think once the my going to attack is already in a very small brain State Ketone bodies. Do not really help to ameliorate it but earlier you take it. You can even stop the attack from developing.
[00:46:41] So so you said earlier that seems a lot of people have warning signs that they're going to have a migrant. I'm sure people listen to this show right now going to go. Yeah, you know, I see auras or I have this simple sensation. That's the time to take the Ketone salt. Exactly. So I don't have this is something we haven't studied [00:47:00] in our clinical trial but there's Anna goats where people say if they catch it really early it helps if it's too late, you know, the Cascade of pain are causing peptides has already happened.
[00:47:10] So when these peptides float around like see GOP is one for example, then that just hurts. So the physiological correlate of the pain is already happening. And then the Ketone bodies obviously can't take that back. Then you have to take painkillers just too. He stopped the pain, but the my underlying migraine is already happening.
[00:47:29] But if you can prevent the the pain causing molecules to be released and the inflammation from happening because you ameliorate that energy deficit right when is occurring then you have a good chance of not getting the migraine. So there is one other question. I forgot to ask and I this is a specifically because I know.
[00:47:48] Dr. Dee who's worked a lot with hyperbaric oxygen. There is some research early research. I many years ago. It may be outdated and meaningless today about cluster [00:48:00] headaches and its relationship to oxygen and CO2 levels in the brain and in the in the blood. And do the this oxygen and like hyperbaric oxygen or even maybe enriched oxygen have any benefits to the to the migraine sufferer?
[00:48:19] That's also a great question. There has been a recent systematic review on the matter that suggests that it's very mild evidence. That pure oxygen. Could be helpful in a migrant attack. And again, this could be explained by if there's more oxygen available than the whole energy production Cascade Works a little bit better potentially the oxidative phosphorylation and that could then produce more ATP and make a migraine less likely or help with an acute migraine, but it's certainly not as strong as evidence as you see in cluster headache, okay.
[00:48:50] Okay, now headaches and migraines are related interestingly. The triptans that are used to treat migraines also work in the cluster headache and cluster headache could also be a [00:49:00] problem with mitochondria and recently there's been evidence that even a ketogenic diet will help with cluster headache also interesting.
[00:49:08] Okay. Now one of the things that I became very aware of several years ago, and this is probably more so thanks to Ron pain. His influence over at Quest when they had the dog Sanctuary. Yeah, so I I know that a lot of dogs with developing seizures and when people took corn and grain specifically not potatoes.
[00:49:35] I mean, it wasn't the amount of carbohydrates in the diet, but it was specifically corn and grains in their diets out of their diet. The seizures went away in the dogs and one of the things that I like to always say when someone tells me about a particular dietary template is a lot of times the reason it's working is not because what you're eating but what you [00:50:00] stopped eating.
[00:50:01] Is there any evidence that there are certain carbohydrates regardless of whether it's because of commercial farming and the way they're. Or something innate about that particular food product like corn and grain that seems to exacerbate the the migraine. Again, this is anecdotal evidence. I know that from some migraine sufferers that gluten is a problem.
[00:50:30] So if you're gluten intolerant, of course if you eat grains that contain gluten and turns on information and that makes you my brains worse. Also God's brain connection, right? If you got isn't working properly not making the butyrate or other short fatty acids that your brain needs to thrive right?
[00:50:47] Then you also get worse migraines, theoretically and and also grains. Simply they contain more of those herbicides and so on which could further damaged [00:51:00] mitochondria and whenever you have damaged mitochondria, you have less energy and then you are more migraine problem and there's other things in grain products like lectins or or other things that the plant is making so it stops stops insects or other things to to eat it.
[00:51:16] Right. If you have more of those those could also turn on inflammation or cause a problem in your in your gut. Potentially even leaky guts and that could contribute contribute to your migraine frequency again. Irrespective of how much carbs are in their potatoes have that less for example, that makes sense.
[00:51:33] Yeah. I know it does and you know Alex Leaf wrote a blog post for my website three or three maybe four years ago that you know that gluten in and of itself is pro-inflammatory and whether or not you have celiac disease or or or you notice symptoms. You may be able to tolerate the symptoms better, but nonetheless gluten does cause a rise in tissue inflammation in the body from its consumption.
[00:52:00] [00:52:00] So here we go again, you know what the whole inflammatory link, you know, exactly. So it's very very worth experimenting. If you are sensitive to a certain kind of food group. Another food group will be KC. Which are the proteins in milk products? So some migraine patients are more intolerant or more sensitive to these casings and it might be worse watching up eliminating Dairy for a while and looking whether one is feeling better because also dare you can cause information if you cannot really tolerate that that's Dairy protein or lactose, but it's oftentimes not lactose but Casey and so that's another thing or sweeteners sweeteners is also want to watch if you have a.
[00:52:41] If you have a very strong insulin response to some of those sweeteners you might again get hyperglycemia, which is very migraine triggering. So that's something else that we expect. That is that's it. So the I want to stay with that first thing that's a very very interesting discussion. So people who use non-nutritive sweeteners, [00:53:00] we know that glucose signaling begins in the tongue.
[00:53:05] So the body anticipate. From the level of sweetness that the tongue senses and that there's sugar on its way and so it preemptively starts to produce insulin. But when no sugar shows up what ends up happening is if your blood sugar was 90 milligrams a liter and you use something very sweet that has a non-nutritive sweeteners in it and no sugar shows up.
[00:53:34] You may end up at 7:00. Because that that insulin that was just produced has nothing to work on so just lowers your base glucose level and it could push you into hypoglycemia. This is what you're describing here. Right you explain that perfectly exactly and this might vary between different sweeteners and some people so some people get away with stevia.
[00:53:56] And it's not so insulin or genic but [00:54:00] after Stone, so it's really worth testing. If you have a glucometer at home, you can just take some of that sweetener and then there's no direct test for insulin. But if your blood sugar drops after then you can be pretty sure that it's that it evoked an insulin response in yourself.
[00:54:17] Yeah, and I yeah, I'm sorry go go go go go. The last thing I wanted to say is alcohol what a lot of people. I mean, I'll go I love red wine or a blast here and there but alcohol is a poison. So it's your livers first priority to metabolize and this is also very important in the framework of a migraine patient.
[00:54:36] If you don't want to run low on energy to burn you should never drink without eating because your liver will be busy metabolizing alcohol and will not have time or capacity to make ketones or glucose. So you're going to run into a hybrid leukemia when you sleep or whatever if you drank alcohol on an empty stomach and I would always advise have alcohol with [00:55:00] food and if you were drinking more than you should then have another late night snack before you go to bed so that you can sustain your brain function until you wake up the next morning and can eat again.
[00:55:10] That is interesting. That's really if you know, I talked about this on the show a lot. Alcohol doesn't we don't have an ethanol receptor alcohol gives us a buzz because it literally poisons the Gaba receptor in the brain and and hence. The word intoxicate has the word toxic in it. Alcohol is a neurotoxin and you know, it's really look I like a glass of wine.
[00:55:40] Don't get me wrong. I Lisa and I went out the other night. I said, I'm not going to drink I ended up having two margaritas. That's a not drinking night for me. Right? So but I always feel like crap for a couple days. And now I'm at the point where I'm not I really am not drinking anything for a while.
[00:55:53] I'm giving myself a few months off but this love affair we have with alcohol [00:56:00] is bizarre to me because. Chances are small amounts of mercury would give you a buzz. But no one is saying hey, let's lick lets, you know lick the thermometer Mercury and get a buzz because they're like, oh no that's poison that causes brain damage.
[00:56:14] Well, so does alcohol. Yeah, I agree. I think for me also, it's probably if I'm completely honest to me. It's more of those social pressure than the taste or the feeling or anything else and that kind of. Society image that's if you have a glass of. I'll call you you have now a relaxed time or you have a better time with your friend or you deserved a break or I know this all these positive connotations for having a glass of wine or beer with friends or having a good night.
[00:56:45] I think you probably could have the exact same night without drinking alcohol in terms of fun. But yeah, I'm not sure. I'm still trying to figure out how to not look I have to I have to be honest. Okay. I always feel better and I [00:57:00] always have more fun. When I've had a few drinks and it's the truth, there's no doubt in my mind.
[00:57:05] It's not I don't drink because of social pressure. I even said it to at least see the other night. Why why is something that feels so good and tastes so good have to be so damn bad for you. Yeah. So yeah, I don't know for me. I but I'm a man. This is a migraine patient talking right if I have. Two glasses of red wine.
[00:57:25] I'm ready to fall asleep. So it makes me at some point. It makes me really tired. So so for me, I mean, I also enjoyed I think maybe in the future when all the heavy metals are gone. I can I can be more more outgoing or happy on alcohol. But yeah, it doesn't always give me the bus so you can also make me make me tired.
[00:57:44] But it totally depends on your how well you can metabolize alcohol also, so there's very quick alcohol metabolizes that won't run into any or much of a problem and there's some there's people that cannot metabolize alcohol so quickly and those are probably the ones that should [00:58:00] stay away from it more and I'm just want to say one more thing and that's the concept of camisas Soho mises meaning that you basically what doesn't kill you makes you stronger.
[00:58:10] So there's even research that should suggest that slow quantities of alcohol can be beneficial because it helps your brain detox on a more General basis. It's like a bit similar to the concept of vaccination, right? You give non-toxic or non-harmful parts of the virus so that the body can prepare for for the real thing when it comes right out.
[00:58:33] I think with alcohol we certainly if you can metabolize alcohol at some point. We probably have the. Of mrs. Kicking in that's low quantities can't even be beneficial. So I want to leave you with this. Thought. I want you to start. Okay, so iron gets trapped in tissue iron causes nerve damage iron causes demyelination when the blood [00:59:00] gets too full of iron, the body produces ferritin ferritin is designed to take the iron out of the blood and stored in tissue.
[00:59:08] Iron needs to be added to some of your research and ferritin levels and not indicative of iron levels. You can increase ferritin levels by staying in the Sun by taking large doses of Vitamin C by using melanotan to the injectable peptide for tanning. Those things will increase ferritin people need to look not at ferritin, but at TI BC, which is actual total iron load in the body.
[00:59:36] They can do blood tests just for that. I would like you to stop paying more attention to iron because here's why so one of the think so my liver is not functioning properly because of the iron overload. Oh, yeah. Okay is oxidative stress pure. It's the most it's the most it's the most oxidative of anything we consume iron is like [01:00:00] eating.
[01:00:01] That's what it's like you want Harden, but you don't want High free Iron it's toxic and it's a potent migraine trigger when I used to use an iron pan for frying things. I would get an a migraine within half an hour after eating. Yes. No. Free Iron and also if you get free iron tablets, it's the worst thing you can do.
[01:00:18] So yeah free Iron toxic if you want to increase your iron level, I suggest using lactoferrin. It's also you can also use that to catch free Iron because it's got its like a ferritin molecule, but it's the immune system of a baby it comes from the first mother's milk avocado. And so. Lactoferrin is is something you can use to raise iron naturally and non-harmful way or to catch free Iron by yeah, in fact, one of the one of the things that we've discovered this is something else to see Ron Ron pain and I were talking about this because colostrum has higher levels of lacked Affair and then the next regular whey protein and lactoferrin, maybe what balance.
[01:01:00] [01:01:00] Our ancestors from developing iron overload because they were drinking whole raw unadulterated milk, which has higher levels of lactic fairness lactoferrin has the ability to bind to iron and you can excrete it then. Yeah, you are so well informed that's awesome few people know this. Good afternoon.
[01:01:19] It was of lactoferrin and that can be used to neutralize that the iron so doesn't do all this oxidative damage to your DNA and your proteins and it's a fantastic tool that I've come across recently and it works both ways. So it's like an adaptogen right? It captures the free Iron but it also provides you with a little bit of natural iron.
[01:01:40] Yeah. Yes. This has been a fantastic discussion. Have we missed anything that you wanted to discuss? I'm just checking who my notes if there's anything. I think know maybe it's nice to finish with a notion that migraines are actually an Adaptive response of the brain trying to protect us from harm [01:02:00] rather than being this nasty pain causing think that is crippling Our Lives you we used to say that pain has a warning function, but in a chronic pain State, it's lost the morning function and I think in my room that just isn't the case the migraines are warning.
[01:02:14] That the brain is low on energy and that oxidative stress is high and that we need to change something. So I would love listeners to think about their migraines this way to embrace them more and appreciate them for what they are and do the necessary changes in their diet and lifestyle to restore brain homeostasis and get their lives back this way Elena.
[01:02:34] Thank you so very much for being on the show today. Thank you so much for having me. I loved it. 100% And yeah, I hope it was useful and thank you for the honor to having me very good. Take care of yourself. We can all stay in touch with the land of gross by going to Twitter or YouTube a she is Elena ele NAC gross on Twitter and she just search for Elena gross on [01:03:00] YouTube.
[01:03:00] There's great videos there pass them around to your friends help someone. Who suffering with migraines and change their lives and we will see everybody tomorrow with more supremum radio. Thanks for listening today.
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