Dr. Elena Gross
Appearances
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And so we did the first ever clinical trial on exogenous ketone bodies in a patient population in tiny bars, Switzerland. I did my PhD there. Never regretted it. Now I have a startup working in that space. And I'm down to less than one migraine day a month, literally. It took a lot of trial and error to get there. It wasn't like I figured this out and then two days, two weeks later, I was fine.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
It took me years to figure out all the things that you mentioned in the four migraine pillars and learning about metabolism. But when I learned about metabolism and really got my own brain back, I realized that Whether you get migraine or Parkinson's or Alzheimer's may be primarily genetic, but how to get out if you have a metabolic problem can actually be fairly similar.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But firstly, it's really this... Very strong pain in the brain, typically half-sided, can be both-sided, and it comes with associated neurological symptoms such as light sensitivity, so light hurts, noises hurts, even smell can hurt. You get nausea, some people throw up.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And that all of these different conditions, while looking very different on the outside, if they have a metabolic root cause, then the keys or the path to getting better is actually fairly similar. Now, in the VC, in the vestibule, nobody would believe you, even the scientists will.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
When you say that a metabolic Alzheimer patient and a metabolic migraine patient may have more in common than a hormonal migraine patient and a metabolic migraine patient, nobody's going to believe you, right? So that was the tricky bit 10 years ago. So I mostly talked about migraine.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But honestly, I do believe that we need to identify metabolic subgroups or certain subgroups with a common root cause. And then these can be very similar across groups. civilization diseases, which means they're mostly lifestyle or environmental related.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Absolutely. Yeah, you need to hit the nail on the head. And luckily, I studied psychology before, so I knew of twin studies that if you take identical twins, right, and you put them in different environments, and this could just be different families that feed them different things or that give them more or less love or whatever, they have a completely different outcome.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But they're 100% genetically identical, right? So this whole idea, it can only be genes. was never really appealing to me, even as a 20-year-old, right, when sitting at the top neurologist's practice who was telling me, well, it's primarily genetics, not much you can do, but you can try this drug. So what I started to learn is always trying to look at things from an evolutionary perspective.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And that's made sound odd, basically trying to think about what was life like 10,000 plus years back before we had agricultural revolution, before we started moving to cities, before we started making new chemicals, right? What was life then? What were humans born into? What were the challenges and the lifestyle we had then?
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Movement makes it worse, so with a tension-type headache, you can go outside, you walk for a bit, you drink some water, it gets better.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Of course, we'll never know 100%, but that's how I try to answer problems. And what could be the adaptive advantages of anything we see today? Now, what has changed in that time? There's so many different things, but just to put it into maybe a pathway first, I think everything negative we do currently actually is elevating reactive oxygen species.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That sounds very complicated, but many of you have probably heard of this thing called oxidative stress, which is basically when these small bombs, free radicals, are very reactive molecules, a bit like a bomb, that whenever they touch something, it explodes and they cause destruction. It's the primary driver of aging and inflammation, most civilization diseases as it is.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
migraine will wake you up in the night you can't sleep through it you can't walk that makes it worse and it really is moderate to severe mostly and in its worst form its chronic form it basically deprives you of life it's the presence of pain combined with the absence of life because you will miss important events of your kids you will miss all those school trips you will miss school itself work
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So we have these free radical bombs and we have two little bond neutralizers. The bond neutralizers are antioxidant enzymes. Now, what is actually in our world is elevating these bombs and making us sicker. This is, for one, you already touched upon it, is the food we eat.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
In the last 100 years, not 100,000 years, just 100 years, I think 80,000 new molecules have been introduced in our world and are ending up in food. Either directly, because there are allowed dyes or... just to random additions that have just been approved or indirectly just because they've sprayed on our soils or they end up in water or air.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So we have a lot of toxins and we are not even beginning to understand how bad these are for our bodies. This could be heavy metals, it could be fat soluble toxins, all sorts of things. Actually, if you analyze your blood, I recently did, it's shocking what you find. Even diesel fumes, it's insane. So you have the presence of things that weren't there.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
You have also the presence of highly processed foods that weren't there even 100 years back, right? You look at pictures of American beaches 100 years back, almost everyone's slim, right? They were not all ketogenic. They were not all on a perfectly paleo diet.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
They didn't have the chemicals and they didn't have the processing, which means the high carbohydrate foods, high sugary foods, processed seed oils, processed whatever it is, like not even food anymore, right? So that's the presence of things that weren't there. But then you also have the absence of certain things, which is nutrients. Our soils are more and more deprived.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Even if, like me, you try to eat a whole food diet with real fruit and vegetables, depending on what soil they're growing on, they might not have all the stuff you need, right? So it's really hard to get adequate nutrients anymore just because even the best of our foods... have been so processed or growing on soils that don't have the nutrients anymore.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So absence of nutrients, absence of sunlight, absence potentially of movement. Now, sometimes in the case of migraine, you can then have the presence of too much movement. So instead of going for longer walks or lifting some stuff in your garden, you might now end up on a treadmill for 60 minutes. And that is too much oxidative stress.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Or you might do high intensity interval training, which can be great for some, but for somebody with migraine genetics can be a big trigger, right? So also physical activity can be beneficial or stressful if done wrong or in excess. Some other harmful additions that are not on the chemical space, but on the physical spectrum, and this would be blue lights.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Blue lights increase oxidative stress not only via your retina in the eye, but even via the skin. So if you're sitting in front of your laptop anymore and you're wearing one of these blue blocker glasses, which I would very much recommend even in the migraine case, right? You still need to watch out for the blue light that is radiating through your skin. Increases oxidative stress by over 50%.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Then we have the addition of all these different pills, drugs. For example, the contraceptive pill that is handed out like candy to women. increases oxidative stress again by about 50%. When I did my studies back then, I added this question, when did your migraine get worse or start? When did you start the contraceptive pill?
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And there was a very interesting correlation that it was about half a year apart that it either became chronic or it even started. I was prescribed the contraceptive pill with 14 because I didn't have a regular period and my bones didn't seem to have enough estrogen. So they gave me a contraceptive pill that doesn't even have real estrogen, just a mimetic.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And half a year later is when I got my first migraine. Now, everybody's going to say this is just a coincidence. I don't believe in it. So that's one thing also that so many women, of course, they get their freedom back and all of that. But what we put in our body on a daily basis...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Nobody really usually would take you seriously. I think it's changing, but it was also stigmatized a lot. So really what I want to do also with my work is that it's real. It's not a psychological issue, even though in some people it can. It's a real disorder. It's a real problem. It's painful and it means lack of life, even if you're not dying from it, at least not immediately.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
mimics of hormones that are not the actual molecule of the human identical hormones without knowing any of the consequences really without any informed consent it's really quite criminal in my perspective so it's the other thing what else are we putting in our body and then last thing and i think it's a lot and maybe drew you have some points to add last thing
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
A rule that I abide to now is don't put on your skin what you wouldn't put on your tongue. Because we put a lot of things on our body and skin thinking that's fine because it's not going to end up in your blood, but it will. So really watch out for hygiene products. Water, air, all of that stuff. But really also what you put in your hair and on your skin really matters as well.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And what you clean your house with because that's going to be breathed through your nose. Perfumes. Perfumes, 50% of perfumes contain toxics that are not regulated. And your nose is the only place where the blood-brain barrier that we talked about earlier is actually broken because otherwise you wouldn't smell. So via smell, these toxins have a direct entry into your brain.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So we talk about cigarette smoke a lot these days. That's amazing. But perfumes are your new cigarettes.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And that's migraine story, which I just want to add that because that's the other chapter I barely ever talked about is what came later that was even worse. I had chronic fatigue syndrome. I still have it a bit. I was bedridden for a year twice in my life. And that is very related. It's broken mitochondria. I literally had to decide, do I pick up a glass of water on my phone?
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Because I couldn't do both at the same time. And that's something I don't think I've ever talked about on a podcast. But that's broken powerhouses of the cells. And I had so many toxins in my body. My lead was through the roof. I genetically am not very good at detoxing. And my migraine genetic means I'm not very good at making energy. And that was close to killing me at a point.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So that was also part of my medical story, which is why I know so much about toxins and mitochondria in general now, because I also needed that to survive, basically. And nobody knew what was going on.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Thanks, Drew. Yeah, so the disappointing answer will be that this is very individual. There's a few rules I think that are universal for everyone. And there's a few things that you literally have to figure out and see what works best for you. So I started off... And I wanted to go ketogenic.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, there wasn't a lot of information out there, but I really thought that I need to get into ketosis, which I think at the time was probably the right call. I started out eating a lot of nuts and they have carbs too. So I failed a bit, lots of protein, lean protein, which didn't work. But at first I went ketogenic, but I was still eating dairy, cheese, you know, all this stuff.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I got into ketosis and it did feel a lot better for my brain, for sure. But my body didn't feel at its best. With a very strict ketogenic diet, you have lots of fat, as you know, like 70 to 80% of your calories have to come from fat. I was eating a lot of dairy as well, which I now know was a bit problematic for me, which I didn't really realize.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I was not allowing myself any colorful vegetables, really, because they also have some degree of sugar and I wouldn't get my ketone bodies high enough otherwise and no fruits at all. It was very restrictive. And it was good to get me into ketosis. I think that was necessary. But I knew and I felt like I'm not going to be able to do a super strict ketogenic diet for a long term.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
This is really one thing that has changed my life and has the potential to change the life of many. If we stop thinking about very common civilization diseases, and I'm going to call anything a civilization disease that is more than a percent, because that really is not primarily a problem of genetics, most likely, but of lifestyle.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Also, now I know, you know, the liver is actually the organ that primarily turns this fat into ketone bodies. Now, what a lot of migraine patients may also experience is that they have overused medication, sometimes for decades, like me, just to survive, right? You have to function. You take painkillers day in, day out, usually, or you take some stronger drugs.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So the liver function is already suffering. Now, if you add a very strict ketogenic diet, the liver must do two things first. For one, it must make sure you have adequate ketone body levels to supply your brain and your heart with adequate energy because it cannot just take the fatty acids as they are. It must also ensure now that you have adequate glucose levels.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, a healthy body can make all the glucose you need, but it depends on the liver making that glucose. Now, what I was figuring out at the time is that actually my morning blood glucose was rising.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
was getting higher and higher and that's a good indication if that happens to you that your cortisol is high your body is stressed your liver is struggling a bit this is when i realized okay i probably have to put in some more carbs now i still needed some ketone bodies This is when I realized and reached out to Dominic D'Agostino in the US and Patrick Allen as a first chemist.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Then maybe there's a way to make those ketone bodies in a lab rather than forcing my liver to make those, even though it felt like it was struggling a bit. So my way actually even early on was that I went on a low carb diet, a low GI diet. And I have been experimenting with sometimes more carbs. Like even now I eat sweet potatoes and fruit again, but I've come a long way.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But just low carb, not enough that my liver doesn't have to make all the glucose, but I get some glucose from outside. And then I was basically supplementated with a very...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
first version of my product microcats or brain ritual at the time so exogenous versions of ketone bodies in addition to a diet this doesn't mean everybody has to go this way so you will see that there is really like migraine is a spectrum there will be a spectrum of what you will basically require as a migraine patient we see some people that just do a low GI diet what is that so the first step in every single patient is you have to get your blood sugar stable
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, what you do when you go on high carb diets, highly processed diets, is especially migraine, your glucose thermostat is broken. So usually you eat glucose or sugar, carbohydrates, and then your body senses this much sugar has gone in. Now we need exactly this much insulin, which is the hormone that grabs the sugar and brings it inside of the cell. And then you're back to baseline.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, when something is working and that goes like this, it's very cool. You go up and then you go down to baseline. Now, migraine, sugar comes in. If a lot of sugar comes in, the insulin answers too late. And then it's like, oh, there's still too much glucose. We have to send more insulin. Then you send much more insulin than you have the glucose. And then it goes like this.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And lifestyle includes the way we're born, all the way to what we eat, drink, our friends, our sleeping behavior. All of that is kind of the environment, the lifestyle, right, that is changing the expression of these genes. So let's say anything that is very common is a civilization disease.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And it goes down way below your baseline. So you're actually hypoglycemic. You have too little sugar. Now, what does this brain say you, tell you now? It says, oh my God, we're hungry, we're starving. You have to eat more food. Now you eat more sugar. And then you have this rollercoaster and it's very bad. And this will mean in this undersugar period, your brain will be starving.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So the first step, even before you know whether you have glucose problems or not, is to make sure you have adequate glucose all the time for your brain. So the minimum is low glycemic index diet. That would mean you can still eat your maybe sweet potato or maybe whole grain rice sometimes, even still your food and veg, cut out all the...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
cut out all the sugar, all the process, real food, non-negotiable, eat real food. Now already a good fraction of patients feel better. This is not even going ketogenic, right? Now what we also must ensure in order for your cells to make energy, your mitochondria, your powerhouses to make energy, they don't just need the fuel source, whether that's ketone or glucose, they also need micronutrients.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And this is a bit like I'm not good with cars, but a car needs water and oil in addition to the fuel to actually drive, right? So we have to give the mitochondria everything they need and the enzymes need. This is where your trace minerals, your minerals, your antioxidants, your fat-soluble vitamins, all of these things come in.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So that's the next thing to ensure is that you actually are getting everything you need. If you're magnesium deficient, Your body could be warning you, you might not be making enough energy, but that can be fixed. If you don't have enough vitamin D, that's a problem, right? So that would be the next level that you fix that. So we're talking about the pillars.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
The first pillar would be stabilizing blood glucose. Real foods, something that people tend to overlook is that your blood glucose is not only influenced by your diet. When you don't sleep enough, your blood glucose will rise. Now, if you've ever worn one of those trackers, you will see that you have a bad night's sleep. It will rise dramatically. If you have stress at work, it will rise.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
If you have a latent infection, it will rise. If you are allergic to something you eat, blood sugar will rise, right? So there's so many different areas that we don't pay a lot of attention to that can mean your blood sugar will rise more than it should. So all of these things, need to be taken care of to stabilize the blood sugar.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
First step, so your brain gets added with glucose, at least, if it can handle that. If not, you'll notice, not good enough. Second, micronutrients. Third pillar is now tackling, very importantly, the oxidative stress part. That's those three radical bonds that we talked about. Now, if you have more of the stressor than you have of the stress neutralizer, you will get in trouble. You will age.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, what we're currently doing as a civilization or also as a field, a medical field, is that we say, oh, there's migraine, there's Alzheimer's, there's Parkinson's, and we treat all of these as if they were one disease with a single root cause. Now, one of the things I learned is that migraine has several different root causes.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
You will get diseased. It's not good for you. Now, what do you do here? This is what we already talked about. Tackling stress, but also stress from the chemical sense. This is toxins. Hygiene products, your beauty products, your cleaning products, the water you drink, the air you breathe. This is physical stressors.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
don't do more physical exercise than your body can handle because exercise is oxidative stress. If you can handle it, you grow, you get stronger, you build muscle. If not, you actually get weaker, right? And then there's psychological stressors that will make oxidative stress. This could be your...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
parents or your boss or a co-worker or somebody who's toxic in your life, really identifying these people that cause more stress than benefit and trying to get rid of them where possible or at least changing your own response. This also will include perfectionism. It's trying to do everything at 100%. You set yourself up with failure, right? And that causes stress.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So trying to do more an 80-20 principle. 80% of outcome for 20% of the energy. And then you want to build up your own antioxidant capacity. And this can include, again, some micronutrients. You can take antioxidants in a powder form. like in MygoCat or other products. CoQ10, for example, is a famous one. Ketone bodies themselves are antioxidants.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So really strengthening your antioxidant system will also include eating real food, right? Then lastly now, if none of this is working, and this goes for migraine, but potentially other brain issues as well, this is when you really want to introduce an additional fuel source for the brain, additional to glucose. And you have to fix the glucose first,
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And now if that is not good enough, then it can be great to introduce ketosis. Now ketosis can come via the diet. If your liver is handling this, if you feel good after an adaptation period, fantastic. You don't have to do anything else. If you struggle with that, then maybe a high quality exogenous source can be beneficial. But it can also be a combination.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
This is really up to the individual person. But that is why I say it's the pillars, because really some can already benefit from low GI or a low glycemic index or a low carb diet. And some really have to go very strict all the way. And while you're doing that, now this is the last layer of complexity. I really encourage people to watch out for food sensitivities.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That's something I have not really done. I mean, the gluten is out anyway, right? But dairy was a big issue for me. I didn't want to believe it. I live in Switzerland. We have the most amazing raw milk, you know, cheese and fondue and raclette and all of that. I just didn't want to believe it. But I'm much better at leaving out dairy. And there can be other things.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Even vegetables are not always your friend. I mean, animals can run away. They don't need to have any chemical defenses. Their defense is legs. A vegetable doesn't have legs. Their defense is chemicals. Now, we know a very famous one is gluten, but there's also oxalates. And there's other... anti-nutrients hidden in those fruits and vegetables that can, for some people, be problematic.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
and hence several different subgroups maybe that have a different root cause. And I think this could be actually true for a lot, if not all, common neuropsychiatric issues. And one of them, a very big culprit, let's say, in migraine, and also associated or related, as you said, neurological issues, can be metabolism and more malfunctioning metabolism.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So if you are still struggling and you don't know where it's coming from, sometimes it's also good to do a bit of an elimination and check whether you are intolerant to some of the fruit or vegetable sources.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
I think that's correct. Of course, I will never know 100% whether that is the primary factor. I already said, right, I also had heavy metal poisoning at a time and I still have quite a toxic load in addition to the drugs, stressful on my liver and my mitochondria. So this can also be a reason. I do produce quite a bit of energy from something else.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Technical glycolysis means outside of the mitochondria. So if I take away all glucose, that can also be a bit stressful. But for several reasons, pure, strict ketogenic diets didn't feel 100% right for me or was a bit stressful for my body.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Most people that thrive long-term on a very ketogenic diet are males. Now, if you go back to 10,000 years plus back, it was usually the guys that are off on a trip hunting. I mean, there may be some females that did that as well, but the females were staying home, gathering the food and the tubers and the roots and so on, right? So there could be something evolutionary to this.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
also because it can be sometimes disrupting to hormones. I don't want to discourage any female from staying on a ketogenic diet long-term, but the reports that I've had that especially for women, they can start losing their period. You know, they generally do less well on a super strict, endless ketogenic diet. And I also want to say again,
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That is how we turn, in very simple terms, food into, into energy, but also how we fight off oxidative stress. And we might go into these in a detail. That's one that can be a big factor. It was the biggest one for me. But we know in migraine, you also have hormonal migraine, also known as menstrual migraine.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Tell me one culture where they would not eat honey when they find it, or they would not eat any fruit and vegetable kind of things in the summer when it was available, even thinking about the Inuit, right? I don't think there's a single culture that would completely ignore carbs if it's available to them at some point during the year.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So an endless ketogenic diet may not even be the natural state that a human was born in. But of course, in an epilepsy patient, a migraine patient, where things are already broken, It may require different things to fix it than if we were just living a healthy life without being sick, right? So everybody needs to experiment, but I just wanted to add that to your good points.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Took way too long, actually. Interestingly, my migraine went down drastically, right, when I was in ketosis. And I was doing the ketogenic diet straight before almost a year, at least half a year.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And because I wanted to do it well, and I thought at the time still that too much red meat is the enemy, and I was raised to go low fat and, I mean, at least low sugar, but definitely low fat, mainly carbs, no meat, basically. I was eating a lot of fish instead. And even tuna and all of that. Nobody ever said there could be heavy metals or anything bad of that.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Fish was also always supposed to be healthy. So I ate tremendous amounts of fish. At the same time, I was in Oxford drinking basically the tap water because I didn't know that
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
tap water in Europe could be contaminated and you know that in the UK in very old buildings and that one was from 1427 right you may still have lead pipes so I was getting significantly worse in the sense that I was losing all strength and I would have these infections all the time and I was getting weaker and weaker and eventually got into a speciality clinic
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
where they made this provocation test to assess for heavy metals. It almost killed me, to be honest. That completely got me to 10% because so much lead was mobilized. But that showed my lead was through the roof. Probably a combination of a lot of fish exposure, exposure from when I was a child. We had these, you know, very old ceramic red plates and mug that I was always drinking from.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And then potentially in combination with some lead pipes in the UK, it was just my bucket was overflowing. And that's when I realized, oh, my God, there's these things called toxins that literally have metals around that basically mimic minerals. They replace the minerals. They especially replace iron. And free iron is super toxic. This is another thing we're going to talk about.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So for example, if your very potent antioxidant protection hormones, which is female hormones, for example, such as estrogen, progesterone, but also other hormones, if they're deficient close to your menstrual cycle, You can also get migraine. The migraine is warning you that something is off. So they say there could be a hormonal issue. There might be a psychological issue also.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
My number one migraine trigger always was free iron in a tablet, in an iron cast pan, because it causes so much oxidative stress. It kills. Leads to migraine in 30 minutes. So migraine is a super amazing warning signal. But there I was down to 10% of function, not knowing if I would survive the year, to be honest, calling up on specialists like this couple of specialists in Germany.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
They have a waiting list of two years and they said half of the people on that list are dead by the time they call them. So I realized that's not true for me. I could hardly move. I was just bound to bed. My brain was kind of still working. Maybe also thanks to ketosis in that sense, right? But I lost mitochondrial function because of the heavy metals.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So I just had to read and read and read and try to find experts that can help develop the protocol to safely remove heavy metals and... When I took the first tablet, it felt better on day one. So toxins is an understudied and completely overlooked topic from the medical system. So I always say there's going to be two pandemics that are already happening.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
The first is the food pandemic, which we covered, which is the first area I went into. Reintroducing ketone bodies, micronutrients, that's making a lot of people sick. But it's already starting to become common knowledge, right? Many podcasts have talked about it. Many people that inform themselves kind of know The next pandemic will be toxins. And not just heavy metals.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Heavy metals, you have so-called chelating agents. Not all heavy metals are toxic. Copper and iron are heavy, but they also have a physiological function. Mercury, lead, arsenic do not. But because they're charged, you can use the other charge in a molecule to bind them and drag them out of the body. That's kind of an antidote that we have for heavy metals.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
We don't have an antidote for most other toxins that the world is flooded with, unfortunately, which are the fat-soluble, the hormone-mimicking toxins that are so ubiquitous these days. And for that... I have only recently found something. So I'm still not at 100%. I still can't do much exercise. I can walk again. I cannot go hiking for very long. It is improving.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But my biggest challenge is what to do with all these other toxins that have accumulated in my body because I'm a bad genetically equipped detoxer. My liver isn't working well to begin with. My twin died before I was born. But I found something that's very interesting. This is the last thing I want to say. And I don't want to recommend it to anyone because it's not yet...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
I think approved in the US. But in Basel, we have a machine. It's called an enosphoresis. It just has different systems and a double filtration method that basically is taking out 75% of your blood and then based on a certain charge and size of the molecules. It's taking out autoimmune particles. It's taking out some toxins, misfolded proteins.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I literally have photos of my blood before and after. You can see all these little dirt particles floating around. And that made a big difference for me. And I could also see what else is in my blood that I didn't have a chance to... basically assessed before. So this has helped me personally a lot. I don't think that's necessary for everyone.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But for the canaries in the coal mine like me that are bad genetically at detoxing and there's five genes, everybody can get tested, literally. I think even in the US, that will tell you where you are standing on that front. I think it could be beneficial, but at least having on the radar that you limit exposure to these things. can already help.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And you've talked to Chris Palmer, for example, Brain Energy. We also know that psychological issues, trauma can increase oxidative stress and be causing some of those issues if they're not resolved. Say if you lost a loved one or you have a super stressful job, that can also potentially be a root cause for migraine. So there's several different issues that you can address.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So for some people with heavy metal poisoning that have just been eating too much tuna, literally eliminating exposure, being aware of the problem can take you a long way. For some, they need to help a little bit more, supporting the body a bit more, getting rid of some of those toxins, should that be an issue for them. That's
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
There's basically three molecules the brain can use for energy. One is glucose, you know, that's sugar. One is lactate. Lactate is actually produced when you exercise, and it can also be used by the brain for fuel source, but it's not around a lot. And the third category is so-called ketone bodies.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, ketone bodies, because they're not actually ketones from a chemical sense, that's just a side note, it's not very important. The important thing is it's small molecules, 4Cs, made from...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
long chain fatty acids from long chain fats and because that they're so small they can actually make it through this blood brain barrier and use be used by the brain as an alternative and it turns out even a preferred fuel source for the brain so when the brain has the chance of using both it prefers to use the ketone bodies because they're more efficient energy source so they need less oxygen when they're burned to make the same amount or more of atp
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And they also have a lot of other nice properties. They're antioxidants. We talked about these free radicals that can be so harmful. So they can catch them. And when they're burned, they make less of these free radicals. Now, they're also anti-inflammatory, which is a huge benefit for a lot of civilization problems that we have, right? As inflammation plays a role a lot there.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, they reduce hyperexcitability in the brain. Hyperexcitability plays a role in epilepsy, migraine, and some other conditions. So they have a lot of benefits to them when elevated. But when I say them, really the most potent or the molecule, the ketone body that has been studied the most is called beta-hydroxybutyrate. There's three forms of ketone bodies.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And the one that I have focused mostly for also selfish reasons is actually energy metabolism, which touches especially the brain because the brain is the most energy demanding organ. It requires energy whether we sleep or not, 20 to 25% of energy at all times, even though it only makes up 2% of our mass. It can't store energy very well because there's just no space in the skull, right?
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
One is acetoacetate, and the last one is acetone. Acetone is that fruity smell. You might have smelled that before. Acetone is very volatile. It's gone fairly quickly. But beta-hydroxybutyrate is more like the storage and transport form, and that's really the most abundant ketone body anyway. Now, when it comes to exogenous ketone bodies, they're not all created equal.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
I just want to give some information so people can make their own choices. And I try to be as unbiased as I can. Obviously, I do have my own startup. But there is first, there is when you have a molecule that has different functional groups, like my two hands, right? They have the same fingers, but different ones.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And no matter what I do, even though they have the same formula, I can never align them in space 100% because they have a different alignment in space, even though it's the same ingredients. You might remember this from chemical class way back. That's called enantiomerism, which means that molecules that have different ingredients have different orientations in space.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, when you chemically synthesize a molecule, you often get 50% of these two versions, but the body can only really well use one a lot of the times. Now, with ketone bodies, there's L and D. There may be benefits to both, but when it comes to primarily energy metabolism, the body prefers the D version, this version in space, let's say.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So when it comes to exogenous ketone bodies, and it's just the beta-hydroxybutyrate, I'm going to say BHP for short, bound to a mineral. That's how they're usually sold. So you have the minerals and that molecule attached. That's very natural. You have the choice between the mix, which is cheaper, and the pure D form that is primarily used for energy. So that's one thing.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That's one differentiation. Now, these are called beta hydroxybutyrate mineral salts, BHB salts. They're basically using the human identical, this BHB molecule, and they're binded to a mineral. So then you have this in sodium and potassium and magnesium form and calcium form. There's another way to make that molecule stable that has been used a lot that is called ketone ester.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
You might have heard of that. Now, not all ketone esters are created equal, but a lot of ketone esters as a backbone that binds the BHP are using something called butanediol. Butanediol can also be bought on its own. Now, butanediol in a patient population can be very problematic. because it is an alcohol.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So a lot of these ketone esters have 50% butanediol, 50% alcohol, plus 50% of the BHB that we actually want. Now via synthesis and in the liver, it can be converted to this BHB molecule, but it's eating up a lot of good stuff. Some might know this NAD+, for example, a molecule that's reduced with aging. on the way, and it puts stress on the liver.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, if you chronically want to use exhaustion as ketone bodies and you're a patient that may already have a struggling liver, I just want you to be aware with a lot of ketone esters, you are ingesting significant amounts of alcohol. Maybe fine if you're an athlete,
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
The good news about why ketone esters are so popular, despite their terrible taste as well, is that you can get higher levels because it's metabolized over time and you don't have any minerals attached to it that may be giving you diarrhea. So it has a longer half-life. But it comes with 50% alcohol, which very few people know.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
There's no way to expand. There's just a physical barrier. And then it's protected, luckily, by something called the blood-brain barrier, which only lets through very small molecules and not, for example, big molecules such as proteins or big fats that other tissues can eat. So the brain is in a very vulnerable energy situation. It has a high demand and a limited supply and storage.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So I talked to medical doctors that have tried giving ketone esters to patients and they see signs of liver failure fairly quickly. In healthy people, liver enzymes typically rise over time. So ketone esters are not good for your liver, period. So there you have to make a choice. So that's why I want to say not all exogenous ketone bodies are created equal.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
There's no products that have the pure butane dial. And there again, if you're a healthy person and you just want to have a boost before your sports and so on, it's fine. Just be aware if you are drinking alcohol. And I drink a glass of red wine here and there as well. And I enjoy it, right, by making that conscious decision because I know it's not good for me.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Some people think they're doing themselves a huge favor and I'm not aware that they are actually also drinking alcohol at the same time. So that's the choices we have, the ketone esters and the ketone body salt forms.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Yeah, so we created a brand. It's called Brain Ritual. And the first product, MigroCat, is designed for migraine. It's actually medical food for migraine. And medical food is something that sits between the supplement and the drug space in the sense that it is safe ingredients, but against the disease. So we can say for the dietary management of migraine, it has to have clinical trials behind it.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And really what it is, it does have exogenous ketone bodies in mineral salt form in it. It's an important ingredient. But it's a one-stop metabolism shop. So we have all the fat-soluble vitamins, the water-soluble vitamins, B vitamins in their methylated form, everything in human-identical form. It has the trace minerals. It has L-carnitine to shuttle the fatty acids into your cells.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
It has antioxidants at high concentrations, such as CoQ10. So it's really a cocktail of a lot of ingredients that you need for energy metabolism in the first version designed for migraine. Because migraine studies have shown that, for example, B2 riboflavin, you need crazy high doses for it to be effective. So that's 400 milligrams. That's a lot of riboflavin.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So we have put some of the doses of these nutrients at doses where migraine trials have been shown that you need those concentrations. We're working on follow-on products. We're currently doing a depression trial. And we're also looking into aging. So there will be more products coming out. So one-stop shop, not just exogenous keys. And that's one part of it.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But we also want to tackle pillar two, three, as well as four in that product.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Whenever you are sick, you probably have a bigger demand at things. So this is the same thing. If your car is broken, it needs more than just a car that needs maintenance, right? So if you have to go to a mechanic with a broken car, it's going to require more energy, efforts, and tools than if you just go to maintenance and the car is fine, right? So I see it a bit similar with patients.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Hey, Ju, thanks so much for having me. Yeah, migraine is kind of the unwanted child of neurology. In a sense, it's so, so common. It's very debilitating, but it hasn't been very much studied or studied a lot. And not a lot of focus and research money has actually been going into it. Even though in women under 50, it's actually the number one disabler.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
They just have a bigger demand because they're inflamed and they're sick. Now, magnesium actually plays a role in over 300 enzymes. Also including our enzymes that are making energy. Now with migraine, you have a hyperactive brain. That's a fact.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So people have shown in migraine with neuroimaging that, for example, if somebody who doesn't have migraine looks at a white wall or a stimulus that doesn't change, it will habituate. It will not fire. It will stop firing to reduce energy demand. If a migraine patient looks at a not changing stimulus, it will continue to fire. It won't habituate, thereby spending significant amount of energy.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And that's, I think, one reason that this metabolism is so important for not just migraine, but almost any neuropsychiatric condition.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So research has shown that even between attacks, migraine patients have about 20% less ATP energy in the brain compared to normal people, which is quite significant, right? So you have a higher energy demand met with suboptimal metabolism, which is a lower supply, which is really the perfect storm.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So if a migraine patient, for example, isn't having enough magnesium, then the action of 300 enzymes will be disturbed, but they're already working overtime. So it will hit much harder, right? So if you're fine on magnesium, it won't help you, right? But if you're suboptimal, it will help to increase it.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So that's why migraine studies, they're not all conclusive, not all show a significant effect in migraine. But the ones that do, it's really around the 600 milligram mark. So that's why microcat also includes 600 milligrams of magnesium, whereas a healthy person may get by with 360. So there's just higher demand in some.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That's why magnesium, but equally you could swap it out with say riboflavin, B2, there's been studies. Also at certain doses, very beneficial migraine studies, randomized controlled studies, that again, if you are bombarded with oxidative stress and all migraine triggers have a common denominator, they elevate oxidative stress.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
if you already have a high oxidative stress load, you may require more QQ10 than a healthy person who just needs to basically ward off the normal load, let's say, or the healthy load.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Starting with the first one. Now, for me, none of these worked in isolation. So it was really only when I brought ketosis in and a cocktail of micronutrients and antioxidants that it really helped fully. But for some, like if they're really severely just vitamin D deficient, isolation works. But sometimes you have to do a combination of stuff. just to putting that out there.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now for triggers, iron is an interesting one. Some, this depends again on your genetics, right? My antioxidants defense, because that's also a phase two liver enzyme, is quite mutated. So I'm not good at catching free radicals very well. If you have a mitoimcation with low iron, but strong antioxidant enzymes, they will probably get fine
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
get by on normal iron supplementation at least for a while might even make them better. If you have low iron migraine and you have weak antioxidants defenses or very high oxidative threshold already, then it will probably trigger your migraine. This is why, for example, in our product, we don't have iron because that's a very individual thing. Similar as copper.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Copper is less oxidative stress creating, but also so. So you give me copper, on about day three to four, I get daily migraines. If it's unbound, now luckily there are products such as lactoferrin that has bound iron in it, where iron is bound. Bound iron is safe. Or there's a recent thing that even now I can take. I always had low iron and I couldn't do anything about low ferritin.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And now I found a product that even I with my vulnerable antioxidants defense can take and it's iron bound in a koji mushroom. So it's a mushroom that is injecting that iron and now it's bound in the mushroom. And now I can tolerate that iron. So that's how I see why there's always individual problems, depending on your genetics, that can be fixed with different creative solutions.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, when you talk about what triggers could people be overseeing, this is one. If you feel like something is a trigger and you have your diary, see if somehow it has a connection to oxidative stress. For example, perfume can be a huge trigger for people that they may not realize. Smells. Odors can have toxins in it. Elevates oxidative stress. Tick. There's your explanation.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, people sometimes say weather. And I was like, my God, weather. That sounds so psychological. Like, what's the explanation that a weather change can...
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
can change migraine but they swear by it and i think the patient is always right so here interestingly when your hazard changes the pressure in the air changes with a pressure air change you get a change in oxygen concentration in the air and less oxygen is less optimal metabolism equals less energy And there are studies that show that change in altitude is a very reliable migraine trigger.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So even things like weather changes can be explained if you look hard enough. That's another one that people may not realize is weather changes, actually.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Exactly. No, it's really hard with just the product for, you know, to really fix everything. So my two credos are first, do no harm. And second, let food be thy medicine as much as it can. So that's why, say, for example, the microhead formulation is like a broad baseline that can
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
cover some needs and if a bit of excess it usually isn't a problem unless you're allergic but it doesn't cover all of your needs we covered iron right if you are iron you might have to add or not right or copper and that really needs to be discussed with somebody one-on-one or with each other as you said community is so important because we don't have to all reinvent the wheel so i try to share everything i know we have i have a free youtube course anybody can download a white paper
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
I've written a book. I still haven't gone around to publish, but that even has all the biomarkers in the blood that you can check for different problems. It's like everything I know from the last 10 years put in one resource that hopefully will be available at some point soon. And we have, for example, a Facebook group. It's still small, but Facebook groups allow the chat more easily.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I really hope that's coming together and growing a bit more. I'm also in there answering as many questions as I personally can next to everything. And I love that you say that and really people talking to each other. When you're sick, you really have to be your own detective. And it's literally detective work. You have to do your homework. You have to find the cues.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
You have to write down your hypotheses and then try to disprove them because it's always hard to prove them. But maybe you can disprove them and move on to the next. So really trying to be your own detective. Use your medical professionals along the way as a resource if you can, if you have them. Use your fellow patients as a sounding board. That's what I would probably do.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
If I were in that position again, and that's what I'm trying to do really is, yeah, bringing patients together and really empowering everyone to have the right knowledge to make their own informed decision about how to go forward.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
We have to make a list. We absolutely have to. And yeah, typically the people I would send people to don't have a clue about migraine because nobody really does or almost nobody. But generally, I would say a functional practitioner is the way to go because they will look for root causes.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
They will give you the labs that you're asking for that are outside the just standard, you know, blood count range by looking into the minerals, inflammation, the oxidative stress. And also more and more doctors have reached out to us now that are open.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I think really, I just bought the other day, we have to put a list together of people that are open to this functional, metabolic, toxic approach. The toxic bit is difficult because again, The knowledge is scarce, but there's many people that are willing to learn. And yeah, we might have to go away a bit of education and making a list of people that are willing to support along the way.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
I was actually starting to make a whole new clinic for them, like a whole clinic program, but I just couldn't do it next to being a CEO.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That's a plan for making a clinic that actually helps migraine, like where people really can go to and relax and that has dim lights and the food that they should be eating and the whole analysis. That's still a dream for the future. Yeah.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Thank you so much. And that means a lot, especially since whenever you make the product, just because you had two people like, oh, but she makes the product. She's biased, like as if I weren't a scientist or a patient anymore. So, yeah, this is made to please me, and I'm the worst critic when it comes to what I put into my body. It's called MygoCat by Brain Ritual.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Brain Ritual is the master brand, and we're rebranding because MygoCat sounds a bit harsh. So this will, in the future, be called Brain Ritual, the migraine version of it. So you have to do something for your brain every day. Your brain needs food every day. And you can see, I mean, I'm not sure if you can see this, but that is a list of ingredients
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And they're all in human bioidentical, like the most bioactive form that you can get. And so easily available, don't need to be converted, should be readily absorbed. And you just start slowly so your gut can adjust to the ingredients. But yeah, it's brainritual.com, brainritual.com. We launched in the US six months ago. We have a few amazing testimonials already.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So if you want to share how you feel on it, good or bad, we always get back to you. And yeah, we ship to Canada as well. Definitely share some with you also if you're curious and would like to.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
It's safe. So the good news about medical foods is they're 100% only generally regarded as safe ingredients. It's a medical food. So it's let food be their medicine. As a supplement, the only difference is it's against the disease, meaning that it has been studied in a given disease that has a metabolic component. So it's designed to address the metabolic issue of a given disease.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So it's metabolic issues and migraine, but all ingredients are safe. The only thing that if once we do the general cognition version is that we will decrease, for example, riboflavin that somebody like you may not be needing in such a high dose. But all the ingredients that are on the higher end are water soluble. So you'll just pee out the excess. So it would be amazing to see.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
We've had testimonials. Recently, a colleague, Dr. Jamie Seaman, I don't know if you know her. She's fantastic. She tried it. Her report was her fever. She took it for the headache she had during her infection. Her fever went away for five hours, which is the half-life. Then she came back. She took it again. The fever went away again.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Some crazy things are happening or we had somebody talk about autoimmune getting better, losing weight, all sorts of things or like general headache getting better that we didn't expect at all. They're just coming in. And of course, those are testimonials and need to be taken with a grain of salt. So nothing I say is medical device. It's personal experience.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But yeah, I would love to hear how you feel when you take it. It should be a one-stop metabolism shop. with ketone bodies and a bunch of other stuff that your body hopefully is craving.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I want to be 100% transparent. This is not a metabolism that's not going to fix all migraine, right? But it will help the proportion where metabolism plays a key role. We call it metabolic migraine, right? So if you have hormonal migraine, we know some that are getting better, but they may still need hormones, right? So it depends on the root cause.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So we can't tackle all billion migraine patients at once with this, although we're trying, we're developing other things, but we can hopefully also help other metabolic issues of other neuropsychiatric issues in the future. And maybe with knowledge and everything else that evolves, focus on other subgroups of migraine also in the future.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Thank you so much. This time flew by. It was a great pleasure. Thank you, Drew.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So it's the biggest disabling problem, actually, for women. And if you count men into it, it's still the second most disabled according to the WHO. So it really is a huge problem. What does it mean personally? What does it feel like? Well, first of all, anybody who's ever been a strong pain knows that pain is hard to ignore. Pain is a warning signal that is designed not to be ignored.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Yeah, so I started getting these debilitating headaches, right? I had no idea. My parents had no idea. Bless them. They thought I was being a difficult teenager. So my dad said, I should just get some more sleep, you know, and wake me up from sleep. And eventually we went to doctors and they were thinking, oh, maybe a brain tumor. You never know. So I went from scanning to psychologists.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
It took about a year. And luckily, Dr. Google had just come around at that time to figure out that actually my grandma had these two, these debilitating headache. And then it could be migraine. And then that was the diagnosis was basically confirmed by a big, migraine clinic in Germany.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But just thinking about that this is something that affects a billion people, it takes a year to get a diagnosis, is already pretty crazy, right? It means there's not a lot of focus. And then I figured out later, much later, that there's only one hour of training from medical training of six years. There's one hour training on migraine.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
That's insane, considering that every seventh person suffers from migraine. There's four hours on headache. 90% of people suffer from some form of headache. So that's just insane. So there's really also a lack of knowledge, which we have to change. But once I had the diagnosis, I was thinking, OK, that's a very common problem. Now, surely we can fix it.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But that couldn't have been further from the truth. So doctors were always very positive. We have this drug, we have this drug. They had a lot of side effects. This goes from anti-epileptic drugs over to anti-convulsant drug, you know, as a teenager. Didn't really work. So we wanted to try alternative things like acupuncture and Chinese herbal medicine. Nothing worked for the next decade.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
It went from... like episodic, so occasional migraine to chronic migraine halfway through my bachelor's degree in psychology. I was even thinking I would fail the degree. I wouldn't know how to even pass my degree because I was either on drugs or in pain all the time. And this is when I then started to take tapiramate, which is a potent anti-epileptic drug. And epilepsy and migraine are related.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So what this drug does amongst others, it reduces the hyperexcitability in the brain. So the likelihood that neurons will fire which is relevant for migraine attack as well as epilepsy. What I didn't know at the time is it also improves the survival of our mitochondria, the powerhouses in our cells.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
Now, there is a metabolic link to almost all drugs that are used in migraine, but we'll come back to that later. Anyway, I took that to pass my degree in Oxford then because I then went into neuroscience because I thought I could never lead a normal life or do a normal job anyway. And I was very lucky to be accepted and have a medical doctor there. take me under his care.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So if you have migraine, migraine is actually a spectrum disorder. And it can be very mild from like one or two attacks a year. all the way to being in pain every single day, all the time. And you cannot take painkillers on every single day because that's going to harm your liver. It's going to harm your whole body, right? You get medication overuse, medication overuse headache.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I did both of my master's projects in migraine. The second one in neuroimaging and migraine. So I got to work with real chronic migraine patients like myself. And one day... The scanner broke down. So that poor migraine patient had to come back so we can repeat her scanning. And she walked in and I almost didn't recognize her. She was coming in. She was beaming. She was walking upright.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
You know, she looked like a different person. And you can tell people that are chronic in pain, you can see it. It's not as visible, but you can see them almost like crawling into the lab. Everything hurts. Everything's too bright. She looked so different. And I asked her, what have you done in the last two weeks? And she said, I have been fasting.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And I have literally been having red wine every night, the most potent migraine trigger. I haven't had a single attack. And at the time, I was like, how is that possible? I already thought about migraine being a warning signal and an energy deficiency in the brain somehow. Now this lady walks in, she hadn't eaten anything. How was her brain not starving? Didn't make sense.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So then we had this habit after the scan as a little thank you for the way home. We gave patients cookies. She ate the cookies. And that same night, she had the worst migraine again. She was worse. So I was basically giving her the migraine back. without knowing it, right?
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
And now, I mean, I always like to apologize to these very early patients when I didn't have a clue what I was doing yet for not having an answer and even triggering their pain. When I finally was writing up my master's thesis and everything, I was procrastinating as usual. So it can be beneficial sometimes.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
An epilepsy special that talked about the oldest treatment for epilepsy, which is a fasting mimicking diet. And it even talked about the pathways, potential mechanisms. And sitting there, like all the puzzle pieces fell together and everything started to make sense. It was the biggest and maybe only big aha moment in my life.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
But this is where I knew migraine is an energy deficiency syndrome, but it's also a problem of glucose, sugar metabolism. So if it cannot use the primary fuel we give it all the time, How is it going to work? So that patient that was eating enough calories the whole time was still starving in the brain.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So the realization that calories doesn't equal fuel inside the cells was a big one that I hadn't come across. So she was fasting, but her brain was fueled for the first time ever since she was born, probably. So that was the, okay, this is what I want to do with my life. I need to study this. Now, Oxford is conservative. There was no data on this at the time that this could work.
Dhru Purohit Show
Masterclass on the Root Causes of Migraines and A Four Pillar Plan to Tackle Them Head On with Dr. Elena Gross
So in the end, I had to make the hard decision and actually leave. And this is how I ended up in Basel, Switzerland, tiny Basel, because they said I could do a pilot project on looking at Ketosis in migraine prevention or in migraine management would be the regulatory correct version to say it.