Dietary Supplements for Migraine Prevention - Migraine and Diet

A majority of patients with migraine have tried

using minerals, herbs, and vitamins to treat their

headaches. Patients have different reasons for

using supplements, including the idea that they

are “more natural” or do not require a prescription.

Because these complementary and alternative

treatments can affect pain pathways and other

body functions similar to prescription medications,

it is important to be aware of the nature of these

supplements, including potential side effects and

the quality of evidence supporting their use for

migraine prevention.

Riboflavin (vitamin B2)

Riboflavin (vitamin B2) was studied as a migraine

preventive in a few small trials and found to be

potentially helpful in preventing migraine in adults. However, two pediatric studies with

riboflavin did not show any benefit in children. Even though the evidence from clinical trials

to use riboflavin isn’t strong, both the American Academy of Neurology (AAN) and the

Canadian Headache Society recommend its use in adults with migraine, because it is well

tolerated and side effects are very limited and mild. Some people can experience diarrhea

or frequent urination, and it’s common to see bright yellow urine. The recommended dose in

adults is 400 mg of riboflavin per day, and it can take at least 2-3 months to see benefit.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10) is an antioxidant important for many basic cell functions and has

been studied in migraine prevention. Based on the available studies, the AAN considers

CoQ10 to be possibly helpful in migraine prevention (level C evidence). Even more, the

guidelines by the Canadian Headache Society strongly recommend its use despite the

low-quality evidence because it is well tolerated. Side effects of CoQ10 are rare, and can

include loss of appetite, upset stomach, nausea, and diarrhea. Adults typically use 100 mg

3 times a day, and while the best dose in children is not clear, 1-3 mg/kg is frequently

suggested. Similar to riboflavin, it can take 3 months to see benefit.

Magnesium

Magnesium is a mineral that is important for a number of body functions and binds to

specific receptors in the brain involved in migraine. Low brain magnesium has been

associated with migraine aura. Studies suggest magnesium supplementation can be

helpful for migraine with aura and menstrually-related migraine. Both the AAN and

Canadian guidelines recommend its use for migraine prevention, either as oral magnesium

citrate 400-600 mg daily or by eating more magnesium rich foods.

Dietary Supplements for Migraine Prevention - Migraine and Diet | Ameri... http://www.americanmigrainefoundation.org/resources-and-links/dietary-...

1 of 2 2/1/2016 3:35 P

Petasites (Butterbur)

Petasites, an herb from the butterbur shrub, has been shown to be helpful in reducing

migraine frequency in 3 randomized, placebo-controlled studies. In these studies, the

optimal dose was 150 mg per day and it took 3 months to see headache improvement. For

that reason it has been deemed effective in preventing migraine by the AAN. However,

because of a rare but serious risk of liver toxicity, Petasites has been removed from the

market in many European countries and many headache experts in the United States have

also stopped recommending its use.

Feverfew

Feverfew is an herb sometimes used in migraine prevention. There have only been a limited

number of studies, however, and they have given conflicting results. The AAN guidelines

give feverfew a second-line, level B recommendation for migraine prevention, supporting the

idea that it is probably helpful. Side effects can include abdominal pain, nausea, vomiting,

and diarrhea. Chewing raw feverfew can cause mouth sores, loss of taste, and swelling of

the lips, tongue, and mouth. Feverfew can also increase the risk of bleeding, especially in

individuals already on blood-thinning medications or aspirin. Feverfew should not be used

during pregnancy.

In conclusion, there are many different herbs, vitamins, and minerals that can be helpful in

preventing migraine. Regardless of which one is tried, patients must be upfront with their

physicians about using such supplements and keep in mind that it can take 2-3 months of

consistent use to see benefit. In addition, women who are pregnant or considering

pregnancy should discuss with their physician prior to using any supplements for migraine.

Reference:

Tepper SJ. Neutraceutical and other modalities for the treatment of headache. Continnum

2015;21(4):1018-1031.

19 Mantua Rd. Mount Royal, NJ 08061

Ph: 856-423-0043 | Fax: 856-423-0082

Dietary Supplements for Migraine Prevention - Migraine and Diet | Ameri... http://www.americanmigrainefoundation.org/resources-and-links/dietary-...

2 of 2 2/1/2016 3:35 P