Can a Controversial Diet Help Treat a Hidden Cause of Migraines?

Detailed summary

Migraines have long been linked to blood sugar levels that are too high or too low—but for some people a different kind of metabolic dysfunction might be the real culprit.

Migraines have long been linked to blood sugar levels that are too high or too low—but for some people a different kind of metabolic dysfunction might be the real culprit.

In the spring of 2025, Natalie Mead made a last-chance attempt to treat her debilitating migraines, which had ended her career as a software engineer. She had spent the last six years cycling in and out of the hospital, trying one new medicine after another and cutting out various foods to identify potential triggers, yet was still averaging 28 migraine days a month. “I was spending most of my days in bed, wearing sunglasses or hats inside,” Mead says.

Mead finally decided to switch to a much more severe—and often controversial—diet: the ketogenic, or keto, diet, which drastically cuts out carbohydrates to encourage the body to shift away from using glucose as its primary source of fuel.

She had reached this point after coming across research suggesting that, for some people with chronic migraines, their condition is driven by metabolic dysfunction, or a breakdown in the body’s ability to turn food into energy. A keto diet had helped some of them find relief.

Although Mead didn’t have any known metabolic conditions, such as diabetes or prediabetes, she strapped on a continuous glucose monitor for 10 days to see if it might reveal any abnormalities.

What Mead saw was eye-opening. Every time she ate, her blood sugar soared to diabetic levels, only to crash in an hour or two, to levels that are often considered to be a medical emergency.

This is a condition called reactive hypoglycemia, which isn’t detected by standard tests such as fasting glucose levels and hemoglobin A1C. These rapid changes in blood sugar levels had created a situation where Mead’s brain had to constantly adjust between extreme highs and lows, both of which result in pronounced symptoms.

The idea that there is a potential link between metabolism and migraine is an old one, dating back over a hundred years.

Yet in recent years, there has…

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