Fasting for Migraines: Can It Help Chronic Headaches?

Key Takeaways

• Fasting frequently triggers headaches: In nearly a third of people fasting at the TrueNorth Health Center, headaches occurred as an adverse effect. Missed meals and blood glucose fluctuations are amongst the most common headache triggers.
• Case study reveals dramatic relief: A 52-year-old woman with 16 years of chronic post-traumatic headaches achieved long-term relief following medically supervised water-only fasting and a whole-food, plant-based diet free from sugar, oil, and salt.
• Pain intensity halved: Following her initial fast, her pain intensity was cut in half. After a second fast six months later, her headaches became mild, brief (under 10 minutes), and rare.
• Millions affected: Over 1 million Americans suffer traumatic brain injuries each year, with three-quarters developing chronic pain – alongside limited treatment options.
• Difficulty separating effects: It is challenging to distinguish between the benefits of fasting itself and the ongoing effects of whole-food plant-based nutrition in subsequent years.
• Arachidonic acid promotes pain: Foods high in arachidonic acid (meat, dairy products, eggs) can act as pro-inflammatory trigger foods. Plant-based nutrition lowers arachidonic acid and reduces pro-inflammatory compounds.
• Randomised trial confirms benefits: Migraine patients following a plant-based diet showed significant improvements in headache frequency, pain intensity, and medication requirements.
• Participants refused to switch back: Many study participants felt so much better on a plant-based diet that they refused to return to their normal baseline diet – declaring “No way, José”.
• Autophagy activated: After approximately 16 to 24 hours without food, autophagy kicks in – a cellular self-cleansing process that can reduce systemic neuroinflammation.
• Buchinger method is best known: Developed by Dr Otto Buchinger in the 1920s, therapeutic fasting providing 250–500 kcal daily from vegetable broth, juices, and herbal teas is the most widespread protocol.
• Three-phase approach is essential: Therapeutic fasting requires transition days (1–2 days), fasting days (5–7 days), and refeeding days (3–5 days) – with the refeeding phase being just as vital as the fast itself.
• Recommended only 1–2 times a year: Therapeutic fasting is not intended as an ongoing daily regime, but rather as an intensive therapeutic intervention followed by long-term dietary modification.

What Is Therapeutic Fasting?

Therapeutic fasting refers to the voluntary, temporary abstention from solid food for medical and health purposes. Unlike intermittent fasting and migraines strategies that involve daily restricted eating windows, classical therapeutic fasting is a multi-day regimen, typically lasting 5 to 7 fasting days.

The most widely recognised approach is Buchinger therapeutic fasting, developed by Dr Otto Buchinger in the 1920s. This allows 250 to 500 calories per day supplied by clear vegetable broth, freshly squeezed juices, and herbal teas. A more stringent alternative is water-only fasting, where solely water is consumed – providing zero calories.

The TrueNorth Health Center in California, where the opening case was documented, specialises in medically supervised water fasting for migraines and other chronic conditions. In an evaluation of several hundred fasting patients, nearly a third experienced headaches as an adverse effect. Skipping meals and resulting blood glucose fluctuations are indeed amongst the most prevalent triggers of headaches and migraines.

How, then, can fasting for migraines or chronic head pain provide any benefit at all? The answer may lie not in fasting alone, but in pairing the intervention with sustained, long-term dietary changes afterwards.

Water Fasting for Migraines and Chronic Headaches: The Case Study

The case report published by the TrueNorth Health Center documents a 52-year-old woman suffering from chronic post-traumatic headaches. Following a traumatic brain injury, she endured unremitting pain for 16 years – every single day, around the clock.

The patient had already trialled an extensive list of medications without success. Her quality of life was severely impaired. When conventional treatments failed, she opted for a radical approach: medically supervised water-only fasting followed by an exclusively whole-food, plant-based diet free from added sugar, oil, and salt.

The outcomes were remarkable: after her first fast, her pain intensity was cut in half. Whilst she still experienced daily headaches, she had pain-free intervals for the very first time. Following a second fast six months later, her condition improved dramatically: the headaches became mild, lasted fewer than 10 minutes, and occurred only rarely. This improvement was maintained months and years down the line.

According to estimates from the CDC (Centers for Disease Control and Prevention), over 1 million Americans sustain traumatic brain injuries each year. Roughly three-quarters of those affected go on to develop chronic pain. In managing this debilitating and treatment-resistant condition, conventional avenues remain limited: pharmaceutical drugs offer modest efficacy, whilst invasive surgical interventions involve severing nerves supplying the head.

The question remains: was it the water fasting itself, or the subsequent plant-based nutrition, that brought about such profound relief?

The Role of Plant-Based Nutrition

Disentangling the individual effects of fasting and diet is challenging, as the patient maintained a strict plant-based diet following her fast. Scientific research suggests that both elements may play a synergistic role in mitigating neuroinflammation.

Alongside analgesic medications that relieve pain, certain dietary components act as pro-algesics (pain enhancers). A primary culprit is arachidonic acid, a polyunsaturated omega-6 fatty acid found predominantly in animal-derived foods: meat, dairy products, and eggs.

The body uses arachidonic acid to synthesise a series of pro-inflammatory compounds known as eicosanoids. These signalling molecules can amplify inflammatory cascades, drive neuroinflammation, and increase pain sensitivity. By adopting a whole-food, plant-based diet, dietary intake of arachidonic acid is drastically curtailed.

At the same time, plant foods are rich in natural anti-inflammatory compounds: antioxidants, polyphenols, dietary fibre, and omega-3 fatty acids sourced from flaxseeds, walnuts, and chia seeds. These nutrients help dampen inflammatory processes and may contribute substantially to pain reduction.

The working hypothesis is straightforward: consuming more plant foods and fewer animal products may alleviate chronic headaches. But does this hold up in controlled clinical trials?

Scientific Studies on Plant-Based Nutrition and Migraines

Researchers conducted a randomised, controlled crossover trial involving migraine patients. Participants were split into two cohorts: one group adopted a strictly plant-based diet, whilst the other received a placebo supplement. Following the initial test phase, the groups switched interventions.

The findings were striking: during the placebo phase, half of the participants reported some improvement, whilst the other half saw no change or a worsening of symptoms. During the plant-based dietary phase, however, nearly all participants experienced notable improvements.

Statistically significant improvements were observed across multiple outcomes:

• Reduced frequency of headaches
• Lower pain intensity
• Fewer total days with headaches
• Reduced reliance on pain-relieving medication

An unexpected complication arose during the study: many participants refused to complete the protocol as designed. After finishing the plant-based phase, they were meant to revert to their baseline diet and take a daily pill. However, because they felt so much better, they flatly refused, stating: “No way, José.”

This phenomenon has been observed in several other clinical trials investigating plant-based diets. When individuals experience profound health improvements firsthand, they are often unwilling to return to habits that caused them suffering – even for the sake of scientific protocol. In short, plant-based nutrition can sometimes work too well to abandon.

Arachidonic Acid: Avoiding Pain-Promoting Trigger Foods

Arachidonic acid is found in particularly high concentrations in the following foods:

• Pork, beef, and poultry
• Eggs (especially the yolks)
• Dairy products (cheese, butter, cream)
• Offal and organ meats
• Fish and seafood (to a lesser extent)

Plant-based whole foods contain virtually no arachidonic acid. The anti-inflammatory effect of plant-based nutrition relies on several distinct mechanisms:

• Reduction in arachidonic acid: Less substrate available for synthesising pro-inflammatory mediators
• Antioxidants: Neutralise free radicals and reduce oxidative stress
• Dietary fibre: Nurtures a healthy gut microbiome, which modulates systemic inflammation
• Omega-3 fatty acids: Plant-derived ALA (alpha-linolenic acid) exerts natural anti-inflammatory actions

In chronic pain syndromes such as migraines, rheumatoid arthritis, or post-traumatic headaches, eliminating these dietary trigger foods and reducing arachidonic acid through plant-based nutrition may provide meaningful therapeutic benefit.

Side Effects and Risks: Does Not Eating Make a Migraine Worse?

Therapeutic fasting is not without side effects. The TrueNorth data shows that nearly a third of patients experience headaches during fasting – commonly referred to as a fasting crisis, which typically manifests on the second or third day.

Other common side effects include:

• Circulatory issues, dizziness, and light-headedness
• Fatigue and low energy levels
• Chills and feeling cold
• Halitosis (bad breath resulting from ketosis)
• Sleep disturbances
• Irritability

In clinical reality, skipped meals and sudden drops in blood sugar are amongst the most frequently identified triggers of head pain. Whilst an unpublished, uncontrolled study previously claimed benefits of acute fasting for migraines, broader scientific evidence demonstrates the opposite: fasting triggers migraines far more frequently than it relieves them during the acute phase.

For this reason, guidance from qualified medical professionals is essential when undertaking therapeutic fasting, ensuring adequate hydration and electrolyte balance. Key contraindications to therapeutic fasting include:

• Pregnancy and breastfeeding
• Current or history of eating disorders
• Severe underweight
• Serious cardiovascular disease
• Type 1 diabetes
• Advanced renal impairment (kidney failure)

The patient highlighted in the case report fasted under strict clinical supervision at the TrueNorth Health Center. Attempting prolonged fasts without medical supervision, particularly when managing chronic health conditions, is strongly discouraged.

Autophagy Fasting: What Happens in the Body?

One of the most important mechanisms behind therapeutic fasting and fasting for migraines is autophagy – a cellular “self-cleaning” process. The term originates from the Greek: “auto” (self) and “phagein” (to eat).

During autophagy, cells break down and recycle damaged or redundant components. Whilst this process always occurs at a baseline level, it is significantly ramped up by fasting. After approximately 16 to 24 hours without food intake, autophagy becomes markedly activated.

The health benefits include:

• Removal of dysfunctional cellular components
• Reduction in inflammatory markers
• Improvement in insulin sensitivity
• Lowering of blood pressure
• Weight loss
• Potential neuroprotective effects

In 2016, Japanese scientist Yoshinori Ohsumi was awarded the Nobel Prize in Physiology or Medicine for uncovering the molecular mechanisms of autophagy. His research demonstrated how disruptions to this process are linked to various conditions: cancer, neurodegenerative diseases, infections, and metabolic disorders.

In people suffering from chronic headache, autophagy could help alleviate symptoms by reducing neuroinflammation within the nervous system. However, direct clinical evidence for this mechanism in humans remains limited.

Practical Application: How Does Fasting for Migraines Work?

Classical Buchinger therapeutic fasting is divided into three distinct phases:

1. Preparation Days (1–2 days)
Transitioning to light, plant-based nutrition. Preparing the body for fasting. Typical meals include rice, steamed vegetables, and fruit.

2. Fasting Days (typically 5–7 days)
Under Buchinger fasting: 250–500 kcal per day from vegetable broth, diluted juices, herbal teas, and perhaps a small amount of honey.
Under water fasting for migraines: Exclusively water, zero calories.

Important: Bowel emptying at the start, usually with Glauber’s salt (sodium sulphate) or an enema. This is not for “detoxification” (a scientifically unfounded concept), but to prevent digestive discomfort from disrupting the fast.

3. Refeeding Days (3–5 days)
A gradual transition back to a normal diet. The first mouthful of solid food is termed “breaking the fast” and is traditionally celebrated – often with an apple.

The refeeding phase is just as vital as the fasting itself. Transitioning too quickly to heavy meals can cause digestive upset.

Recommended Frequency:
Therapeutic fasting is typically undertaken 1 to 2 times per year. It is not designed to be a permanent dietary pattern.

In the case of the 52-year-old patient with post-traumatic chronic headache, water-only fasting was practised, followed by a permanent transition to wholefood, plant-based nutrition without added sugar, oil, or salt. Long-term relief was only achieved after a second fast six months later.

Frequently Asked Questions

Who invented therapeutic fasting?

Otto Buchinger (1878–1966), a German physician, is regarded as the founder of modern therapeutic fasting. After recovering from a severe rheumatic condition through fasting, he developed the Buchinger method named after him in the 1920s. His fasting clinics in Germany remain active today and are run by the fourth generation of his family.

When should you clear your bowels during therapeutic fasting?

Bowel evacuation takes place at the start of therapeutic fasting, typically on the first fasting day or the final preparation day. Glauber’s salt (sodium sulphate) dissolved in water or an enema is most commonly used. Bowel cleansing should not be repeated daily throughout the fast, but rather only at the beginning and, if necessary, once more after 3–4 days.

Why try therapeutic fasting?

Therapeutic fasting is practised for various reasons: managing chronic inflammatory conditions (rheumatism, arthritis), metabolic syndrome, and hypertension; supporting weight loss as part of a dietary transition; relieving migraine and chronic headache; and providing a psychosomatic reset. Scientific evidence is stronger for some indications than others, with the most robust data supporting its effects on blood pressure, inflammatory markers, and weight.

What is allowed during therapeutic fasting?

During classical Buchinger therapeutic fasting, the following are permitted: vegetable broth (homemade, without salt), freshly squeezed fruit and vegetable juices (diluted), herbal tea and green tea, still water (at least 2–3 litres daily), and small amounts of honey (1–2 teaspoons). Not permitted: solid food, coffee, alcohol, nicotine, artificial sweeteners, and most medications (consultation with a doctor is essential). During strict water-only fasting, exclusively water is permitted.

What happens in the body during fasting?

After 12–16 hours without food, liver glycogen stores are depleted. The body switches from glucose metabolism to fat burning (ketosis). After 16–24 hours, autophagy fasting pathways are significantly activated – cells break down and recycle damaged components. Inflammatory markers in the blood drop, insulin levels decrease, and insulin sensitivity improves. Blood pressure falls in many individuals. Ketones are produced as an alternative fuel source for the brain. After several days, side effects such as headaches, fatigue, or circulation issues can occur as the body adapts to blood glucose fluctuations and shifts in electrolyte balance.

What is therapeutic fasting?

Therapeutic fasting is the voluntary, time-limited abstention from solid food for therapeutic purposes under medical supervision. Unlike religious fasting or intermittent fasting and migraines management routines, it is a multi-day programme (typically 5–7 days) with a clinical objective. The best-known modality is Buchinger therapeutic fasting, which provides 250–500 kcal daily from juices and broth. Therapeutic fasting forms part of integrative medicine and is practised in specialised clinics.

Which juices are recommended during therapeutic fasting?

During Buchinger therapeutic fasting, freshly pressed juices are recommended: orange juice, grapefruit juice (caution if taking certain medications), apple juice, carrot juice, beetroot juice (heavily diluted), and sauerkraut juice. Juices should always be diluted (1:1 with water) and sipped throughout the day. Commercially produced juices with added sugar are unsuitable. Around 250–500 ml of juice per day is recommended, divided into 2–3 servings.

Which day of fasting is the hardest?

The second to third fasting day is considered the most critical phase – often referred to as the “fasting crisis”. At this stage, glycogen stores are completely exhausted, the body shifts into ketosis, and many people experience headaches, tiredness, irritability, light-headedness, and difficulty concentrating. Does not eating make a migraine worse during this phase? For some, rapid metabolic shifts can temporarily exacerbate symptoms before relief sets in. From day 3 to 4 onwards, many report a marked improvement: greater energy, mental clarity, and a sense of lightness. Not everyone experiences a fasting crisis – individual variation is significant.

How do you carry out therapeutic fasting?

Therapeutic fasting should follow a structured process: 1–2 preparation days with light meals; bowel emptying on the first fasting day using Glauber’s salt or an enema; 5–7 fasting days with plenty of fluids (water, tea, broth, juices); daily light exercise in the fresh air; rest periods and relaxation; and 3–5 refeeding days with a slow return to normal food. Important: Anyone undertaking therapeutic fasting for the first time should do so under qualified guidance – in a specialised fasting clinic or with a certified fasting practitioner.

How long should therapeutic fasting last?

The typical duration for Buchinger therapeutic fasting is 5 to 7 fasting days, plus 1–2 preparation days beforehand and 3–5 refeeding days afterwards. The total duration of the programme therefore amounts to around 10–14 days. Shorter fasting periods (3–4 days) are possible, but have less intensive effects. Longer fasting periods (up to 3–4 weeks) are only carried out in specialised clinics under close medical supervision. For a first attempt, a shorter duration of 5–7 days is usually recommended.

How many times a year should you fast?

Therapeutic fasting is typically practised 1 to 2 times per year. More frequent fasting is not necessary and could cause problems for some people. Many experienced fasters fast once a year in spring or autumn for 7–10 days. Therapeutic fasting is not intended as a continuous or frequently repeated lifestyle habit (intermittent fasting and migraines routines are better suited for that), but rather as an intensive therapeutic intervention followed by long-term nutritional changes.

Scientific Sources

• Michalsen A, Li C (2013). Fasting therapy for treating and preventing disease – Current state of evidence. Forsch Komplementarmed.
• Peroutka SJ (2014). What Turns on a Migraine? A Systematic Review of Migraine Precipitating Factors. Current Pain and Headache Reports.
• Zaeem Z, Zhou L, Dilli E (2016). Headaches: a Review of the Role of Dietary Factors. Current Neurology and Neuroscience Reports.
• Finnell JS, Saul BC, Goldhamer AC, Myers TR (2018). Is fasting safe? A chart review of adverse events during medically supervised, water-only fasting. BMC Complementary and Alternative Medicine.
• Goldhamer AC, Gershfeld N, Goldman DM, Myers TR (2017). Challenging Case in Clinical Practice: Long-Term Relief from Chronic Posttraumatic Headache After Water-Only Fasting and an Exclusively Plant-Foods Diet. Alternative and Complementary Therapies.
• Nampiaparampil DE (2008). Prevalence of Chronic Pain After Traumatic Brain Injury: A Systematic Review. JAMA.
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