VANCOUVER, Canada — Preliminary evidence indicates that a daily dietary supplement providing ketones can reduce the frequency of migraine headaches with no adverse effects.
Increasing evidence suggests an energy deficit disorder exists in migraine, the researchers note. By supplying ketones as an alternative fuel to glucose, several deleterious components of the deficit may be avoided.
During a poster session here at the 18th Congress of the International Headache Society (IHC) 2017, doctoral candidate Elena Gross, MSc, University of Basel Children's Hospital, Switzerland, told attendees that although a strict ketogenic diet is known to be beneficial in migraine, it is very difficult to follow long term.
"So the idea was what if a lot of the benefits you get from a ketogenic diet are actually due to the presence of ketone bodies vs the absence of glucose?" she asked. "This is where ketogenic substances came in, and we played around with this quite a lot." She said the predominant ketone body (KB) in a physiologic, endogenous state of nutritional ketosis is β-hydroxybutyrate (bHB).
She therefore designed a drink containing calcium and sodium salts of bHB to raise KB levels in the blood. On a typical Western diet, KB blood levels are 0.2 mmol/L or less. Nutritional ketosis can see levels of 0.5 mmol/L to 8 mmol/L, which is below the level of greater than 15 mmol/L at which ketoacidosis occurs.
To assess pharmacokinetics, 4 women and 1 man with migraine (age range, 25 to 61 years; 6 to 24 migraine days/month) received 10 g of the bHB salts twice a day by mouth in a liquid formulation for 4 weeks.
From a mean baseline of 0.162 mmol/L at time 0, blood levels of bHB peaked 1 hour after ingestion at 0.62 mmol/L, with a concomitant drop of 1 mmol/L (18 mg/dL) of blood glucose.
Participants consumed a mixed breakfast 1 hour after ingesting the bHB preparation but before the blood draw at 1 hour. Blood levels of bHB returned approximately to baseline at 3 hours. After 3 weeks of daily intake, the bHB blood levels nearly halved from 0.62 mmol/L to 0.33 mmol/L at 1 hour after ingestion.