Fasting and Headache.

Purpose of review: This review synthesizes the latest updates in the literature on the connection between fasting and migraine, examining both clinical outcomes and underlying pathophysiological mechanisms.

Recent findings: Although no studies have specifically explored fasting as a therapeutic intervention for migraine, various retrospective analyses suggest that fasting might worsen migraine symptoms in the short term. On the other hand, recent investigations, including several randomized controlled trials, have shown that ketogenic diets significantly reduce the number of migraine days and decrease inflammation markers. Additional research has shown improvements in disability assessments, as indicated by VAS, MIDAS, and HIT-6 scores. These benefits are not replicated by merely administering ketone bodies. Furthermore, genetic studies have found a link between glycemic processing and the occurrence of migraine. There is accumulating evidence that ketogenesis can reduce both the frequency and disability associated with migraine, likely through the reduction of systemic inflammatory markers and diminished cortical excitability. However, the potential benefits of intermittent fasting on migraine prevention remain underexplored and warrant further investigation.