Potential Protective Mechanisms of Ketone Bodies in Migraine Prevention.
Level 5 - mechanism / opinion, no new human data
Narrative review relying on mechanism-based reasoning and animal literature without primary clinical trial data.
PubMed 30974836 · doi:10.3390/nu11040811
What was done
This narrative review synthesizes clinical, biochemical, genetic, and experimental animal literature to examine how the ketogenic diet and ketone bodies—specifically D-β-hydroxybutyrate (D-BHB)—may counter putative pathophysiological mechanisms involved in migraine prevention.
What was found
The abstract reports no primary quantitative data or statistical effect sizes. It describes proposed mechanisms whereby ketone bodies could mitigate migraine pathophysiology, including providing an alternative cerebral fuel during glucose metabolism abnormalities, improving mitochondrial function, lowering oxidative stress, reducing cerebral excitability, modulating inflammation, and altering the gut microbiome.
Why it matters
It outlines a comprehensive mechanistic rationale for metabolic therapies in migraine, linking ketone body signaling directly to multiple cellular pathways implicated in migraine attacks.
Limits
As a narrative review, it provides no original clinical trial data or systematic quantitative synthesis. Much of the mechanistic rationale depends on animal models and hypothesis-generating biological reasoning, leaving the relative clinical contributions of carbohydrate restriction versus ketone body elevation unresolved.
Cited by
- supports Dr. Elena Gross and Dr. Dominic D'Agostino published a review documenting that ketogenic diets and exogenous ketone supplements can help manage chronic migraines.