Today represents the first in a multi-part exploration of the connection between diet, supplementation and migraine.
Before we get to the good stuff I must note that today’s article is the direct result of the work of my research assistant Huda Fareed (research) and my Kaleigraphy writing intern Kat Durtson (research + writing) who brought this article to life through their hard work and left me with not much more to do besides some minor review, revision and editing.
I’m confident that anyone interested in the field of migraine will get great value from today’s article.
With that said, let’s get right to it.
The Best Supplements For Migraine – Part I
Written by Kat Durston with research support provided by Huda Fareed
Migraine is the most common neurological disorder globally, affecting approximately 14% of the population and ranking as the seventh-leading cause of disability worldwide.
This often debilitating condition is characterized by recurring headaches which may be accompanied by various other symptoms including nausea, photophobia and phonophobia ( sensitivity to light and sound).
Given the severity of these symptoms it is perhaps unsurprising that one of the hottest topics of research in the world of migraine treatment and prevention involves the use of various supplements.
But with a long list to choose from, which ones are actually worth your time?
This is the question I hope to answer in today’s article.
Let’s get into it!
Magnesium
Magnesium is among the top selling supplements on Amazon and is generally under consumed by Canadian adults when only food sources are considered.
Research has shown that magnesium plays a pivotal role in migraine pathophysiology, including via the blocking of NDMA receptors, an important pain receptor in the human body.
Multiple studies (1,2,3,4) have shown that migraine patients are more likely to be deficient in magnesium during and after migraine attacks compared to healthy individuals.
A systematic review published in the Journal of Head and Face Pain analyzed five clinical trials and found an overall reduction of 22-43% in migraine attacks when supplementing with magnesium citrate.
In fact, magnesium citrate supplementation is also identified as a management strategy for migraines by the United States Headache Consortium (USHC) and the Canadian Headache Society (CHS).
While more clinical trials need to be conducted on the most effective dosage and type of magnesium supplement, it appears that 600mg of magnesium citrate is the recommended dose for migraine prevention as noted in the 2012 Canadian Headache Society Guidelines.
For those concerned about their dietary intake of magnesium being inadequate, this article should help.
CoQ10
Coenzyme 10 (CoQ10) is a naturally compound that exists in our cell membranes and facilitates a number of cellular functions.
Andy has written about it previously, and it certainly is a supplement that attracts attention as it relates to its ability to help with a wide array of issues.
CoQ10 is believed to improve migraine outcomes due to its anti-inflammatory properties and its effect on mitochondrial energy stores, which has been shown to be impaired in migraine patients.
A 2021 meta-analysis out of BMJ reviewed the effect of CoQ10 supplementation on 371 patients with migraine and found that patients who took CoQ10 saw a significant reduction in both migraine frequency and duration, but not severity.
However, multiple recent trials (1,2,3) observed a substantial decrease in migraine severity, frequency and duration with 100-400 mg a day of CoQ10.
CoQ10 may also improve insulin resistance, androgen levels and fertility outcomes in women living with PCOS.
Melatonin
Melatonin, sometimes referred to as the sleep hormone, is secreted by our pineal gland that is most commonly known for its role in modulating our circadian rhythm.
While melatonin supplements are a popular sleep-aid, there has been growing interest in their potential benefits as it relates to reducing migraine frequency.
These effects appear to be due to melatonin’s biological characteristics, including the regulation of neurotransmitters and neural pathways, stabilization of membranes, and analgesic effects.
A 2020 meta-analysis published in the Journal of Pineal Research found that 3 mg of oral melatonin at bedtime saw the greatest improvement in frequency of migraines compared to other standard pharmacological migraine treatments (and it was also the most well-tolerated!).
Further, a 2017 randomized controlled trial found that patients who took a 3 mg oral melatonin supplement saw a significant overall decrease in migraine frequency, attack duration, severity, pain, and drug side effects compared to a placebo group.
Riboflavin
Riboflavin, or vitamin B2, is an essential vitamin involved in many vital metabolic processes.
When taken as an oral supplement, there is a growing body of evidence to suggest that it has a beneficial impact on migraines in both adolescents and adults.
The current scientific belief appears to be that riboflavin prevents migraines by increasing mitochondrial function, which is important because dysfunctional mitochondria have been linked to an increase in migraine incidence.
A 2017 systematic review out of the Journal Of Clinical Pharmacy And Therapeutics concluded the following;
“Riboflavin is well tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient’s migraine headache frequency. “
Due to its limited side effects, there is increased attention in using riboflavin to treat pediatric migraines, including this 2020 randomized-controlled study out of the Brain and Development journal that concluded riboflavin is “safe and effective” for reducing migraine frequency in children.
While research on proper dosage size is limited, it appears that 400 mg/day for adults and 30 mg/day for children is well-tolerated.
Final Thoughts
Today’s article is merely a first look at the many alternative management options that have been studied for their ability to reduce migraine frequency and severity.
You can expect more where this came from, as future parts of my migraine nutrition series will expand upon the various supplemental and dietary strategies available to those seeking to utilize nutrition science in their fight against migraine.
If you’ve read today’s article and feel you need further professional support to navigate and implement these suggestions – Andy is only an e-mail away.
If you are unsure about a supplement and its potential interaction with any medications you may be taking, always consult with your healthcare provider before proceeding.
In the meantime, you can look forward to plenty of more nutrition & migraine content to come.
Written By Kat Durston with research support provided by Huda Fareed and content review/editing by Andy De Santis RD MPH
