Migraine drugs are expensive and potentially toxic, but people who get these debilitating headaches are desperate for anything that can help. No supplement can reverse a migraine once it has started, but some can help prevent migraines or reduce the number, intensity, or frequency of attacks.
More and more doctors are becoming aware of how supplements can help migraines. And in some cases, they’re part of the standard treatment protocol (per the American Academy of Neurology, or AAN), which is very exciting and one of the reasons I love the world of dietary supplements, because when handled appropriately, they can really improve someone’s life!
What is Migraine?
A migraine is an intense, one-sided, throbbing headache that often recurs and is usually accompanied or preceded by sensory changes and other physiological symptoms.
Scientists haven’t pinpointed the exact cause of migraines yet, but they involve vascular and neurological changes in the brain. Some speculate that these headaches may be caused by an overactive “switch” in the brain that triggers the release of compounds that can cause significant pain. Researchers believe there may also be an inflammatory element to migraines.
They’re often triggered by stress, hormonal fluctuations, weather changes, and food (see this page for a list of common triggers). What’s more, an amazing 70 percent of migraine sufferers have a family history of these headaches, so there could be a genetic link.
Common symptoms include throbbing head pain that is incapacitating; sensitivity to light, sounds, and smells; nausea and vomiting; runny or stuffy nose; eye tearing; and vision changes. Movement often makes the pain worse, so many people prefer to rest in a quiet, dark room until the headache subsides.
About 20 percent of migraine sufferers experience “auras”— visual changes such as flashes, zigzags, splotches, shimmering colored lights, or even blind spots—before or during a migraine. (Some studies have shown that people who experience migraines with auras have a higher risk of stroke, and this is an active area of research.)
Migraine Home Remedies
1. Butterbur (Petasites hybridus) up to 75 milligrams twice a day
This plant, which grows in wet marshy areas, contains chemicals called petasites (petasin and isopetasin) that may have anti-inflammatory properties. Taking 75- milligram dose of butterbur (the Petadolex brand has the most research) has been shown to reduce the frequency of migraine attacks by about half (start with this dose and slowly work up, if necessary, to a max of 150 milligrams per day). The maximum response was achieved after 3 months with a product that contained at least 15 percent petasins (always look for this on the label).
Mild gastrointestinal upset, especially burping, was the most common side effect reported.
I gave this herbal supplement a high ranking for three reasons: First, the quality of evidence backing it is better than it is for the other suggestions here. Second, it can be standardized to an active ingredient. Finally, the AAN and the American Headache Society now consider this a Level A recommendation, meaning it has more evidence for prevention than any other supplement.
This means you can go to the store and buy a product that contains the exact ingredient researchers studied in the clinical trials, which isn’t always the case when it comes to herbal products. Butterbur also has a positive clinical history of helping with another inflammatory condition, allergies. In other words, it has a fairly long track record of efficacy and safety in multiple areas of medicine.
Cautionary notes: Butterbur contains dangerous compounds known as pyrrolizidine alkaloids (PA), which are toxic to the liver and lungs and increase the risk of blood clots, but these are supposed to be removed in commercial supplements. Regardless, make sure you purchase only butterbur supplements that are certified and labeled “PA-free.” Additionally, pregnant women should not use butterbur because its effects on the fetus are unknown. Also, never consume this plant in any other form (in other words, don’t go foraging for the plant and make a tea out of it).
2. Vitamin B2 (riboflavin) 25 to 400 milligrams a day
Most conventional medical treatment guidelines recommend this vitamin as an option for migraine prevention. In one study, 56 percent of participants who took 25 to 400 milligrams of B2 per day for a 3-month period cut their migraine frequency in half. Researchers believe the vitamin may speed up brain metabolism by improving how cells use oxygen, which enhances normal brain function.
There is a low rate of side effects, but diarrhea, stomachache, and increased urination have been reported. (Don’t be alarmed if your urine turns fluorescent yellow—it’s harmless.) Always take vitamin B2 by itself—never in a multivitamin or B-complex supplement—so you don’t ingest a toxic dose of other vitamins in the process. Most treatment guidelines recommend aiming for 400 milligrams per day (either all at once or divided into two or three doses) for 3 months, but research has shown taking as little as 25 milligrams per day can be beneficial. Just increase the amount gradually if you don’t get relief.
Now, is B2 a groundbreaking preventive treatment? No. The evidence is good, not amazing, but since the cost and side effects are so low, it makes sense to recommend it.
3. Magnesium 300 to 600 milligrams a day
A deficiency of this mineral can trigger migraines. When magnesium is low, the body generates a compound called substance P, which stimulates sensory fibers in the brain and can lead to headaches. People taking acid reflux medication (especially proton pump inhibitors), those eating a diet high in meat or low in carbohydrates (or both), and women with heavy periods (magnesium is part of the blood) are at risk for magnesium deficiency.
If you’re curious about your levels, ask your doctor for an ionized magnesium blood test; it will give you a clearer picture than the standard total magnesium blood test. (Magnesium supplements may also be helpful for menstrual-related migraines even when levels are adequate because the mineral may not be utilized appropriately.)
Magnesium supplements are available in many forms, but study subjects who took 600 milligrams of magnesium citrate daily experienced a reduction in both migraine frequency and severity (the study included only people who had migraines without auras).
Some data supports taking a daily 400- to 600- milligram dose of elemental magnesium in the form of magnesium oxide, slow- release magnesium, or chelated magnesium, all of which are cheaper than magnesium citrate. However, I think 300 milligrams of magnesium citrate twice a day is the best option because it’s been widely studied, and you can take it with or without food.
The most common side effect is soft stools or diarrhea, so if you suffer from constipation and migraines, you’ll be set! Also, taking more than the recommended amount won’t work better than normal doses. Megadoses (research varies on this, but I say more than 600 milligrams per day) can cause abnormal heartbeat or breathing problems. Individuals with kidney problems (magnesium is excreted by the kidneys) or a history of soft stools and diarrhea (those with IBS-D, for example) should avoid magnesium, unless your doctor clears it.
CoQ10 boosts brain energy metabolism and could cut headache frequency by 50 percent. In one study, a total of 150 to 300 milligrams per day (in up to three divided doses) over 3 months reduced the frequency and severity of migraines as well as nausea, and subjects saw improvements within the first month.
If money isn’t an issue (this is an expensive supplement), opt for the higher dose as it appears to be more effective, and always take it with a meal. There were some rare reports of gastrointestinal side effects, such as stomachache and cramping, and skin allergy, but overall CoQ10 has a good safety record.
5. Alpha-lipoic acid
Alpha-lipoic acid at 600 milligrams per day provided some benefit in a preliminary clinical trial, but more data is needed. Yet, since it is so safe at this dosage, it gets somewhat of a free pass. Give it a try.
6. Vitamin B12, B6, and folic acid
Vitamin B12, B6, and folic acid are crucial vitamins that help the body process homocysteine, an amino acid that has been linked to an increased risk of cardiovascular disease. Extremely high levels of homocysteine may be especially dangerous in people who experience auras, since they’re already at higher risk of stroke. One human study found that 25 milligrams of B6, 400
micrograms of B12, and 2 milligrams of folic acid reduced homocysteine levels by almost 40 percent and decreased the frequency and severity of aura-related migraines. Keep in mind: Homocysteine has been tied to a lot of diseases, and research hasn’t shown yet that lowering levels will significantly impact health, but there does appear to be a benefit when it comes to migraines.
So, what does this all mean? If you have migraines, especially those with auras, ask your doctor for a homocysteine blood test. Also, there is a test available (for the MTHFR gene) that may be useful in determining other potential migraine treatments.
What Supplements Are Useless For Treating Migraine?
This herb is frequently touted for migraine prevention, but not for long if this article has any impact. Feverfew has an active ingredient known as parthenolides, which researchers believe might work for migraines by keeping platelets from sticking together, promoting the release of serotonin, and fighting inflammation.
The problem is that there are just as many studies (and some higher-quality ones, at that) showing no benefit as there are showing a positive effect on migraines. In other words, although many experts recommend it for migraine prevention, I do not. (Sorry, folks. Let the hate mail begin!) Besides inconsistent study results, the side effects—gastrointestinal upset, mouth ulcers, and joint aches—make me nervous when I look at the benefit-to-risk ratio.
Finally, the variation in active ingredients among the different brands is huge, so you don’t really know what you’re getting.
Melatonin at 2 milligrams per day was tested for migraine prevention in a small but good-quality trial with no benefit found over the placebo. It’s great for sleep and jet lag and maybe some other things, but I’m not ready to get excited about it for migraines.
Asking me if probiotics can prevent migraines is like asking me if gummy bears can lower cholesterol. No! Don’t get me wrong. I’m excited about some of the probiotic research, but not when it comes to migraines.
What Supplements Are Suitable For Kids to Treat Migraine?
Migraines affect up to 5 percent of children, and there are some good supplement options out there to help them.
Butterbur (the Petadolex brand) was tested in a small study of children and adolescents with migraines, and it appeared to reduce headache frequency. Children between 8 and 9 took one 50-milligram capsule per day and those between 10 and 12 took two per day (100 milligrams total) for 8 weeks. Another study in children showed similar results over a 4-month period with dosages between 50 to 150 milligrams per day (6- to 9-year-olds received the lower dosages and 10- to 17-year-olds received the higher ones). Butterbur extracts in these studies contained a minimum of 15 percent petasins.
Magnesium supplements (400 milligrams per day) along with either acetaminophen or ibuprofen were given to children ages 5 to 16 who reported at least four migraine attacks per month. In this study, magnesium appeared to improve the effectiveness but not the toxicity of acetaminophen and ibuprofen over an 18-month period.
CoQ10 helped kids (average age 13) at a dosage of 1 to 3 milligrams per kilogram of body weight per day in a liquid gel capsule in one study. Reduced headache frequency and disability were reported.
What Lifestyle Changes Can Help With Migraine?
Identifying your triggers—and avoiding them—is crucial in preventing migraines (See “Common Migraine Triggers,” opposite). Keeping a headache diary (you can easily make one yourself or find one online) can help you track and pinpoint potential culprits. In one study, more than 75 percent of sufferers were able to identify a trigger just by analyzing their diaries.
Being overweight or carrying excess belly fat increases migraine risk because it creates a state of internal auto-immunity and inflammation, which can lead to migraines. In one study, aerobic exercise (specifically indoor cycling for 40 minutes three times a week) reduced headache frequency as well as relaxation techniques or the prescription drug topiramate did.
A low-fat diet (anywhere from 28 to 66 grams of fat per day) is associated with significant reductions in headache frequency, intensity, and duration as well as medication intake. However, was it the reduction in fat, weight loss, or improvement in cholesterol that deserves the credit? Who cares? Heart healthy = headache healthy.
Applying a cold compress to your head can reduce pain (it’s an anti-inflammatory), but heat can make it worse.
Relaxation techniques—including meditation, massage, yoga, tai chi, and acupuncture—can reduce tension and might reduce susceptibility to migraine triggers.
Watch your meds. Be careful about overusing pain medication, even over- the-counter products, for headaches. Always follow the dosing and frequency recommendations on the label (often, you shouldn’t take them for more than a few days a week). You can develop a resistance to them over time, which can bring on headaches more frequently, known as rebound headaches.
What Else to Know About Treating Migraine?
After taking one of the supplements recommended in this section for up to 6 months, have a discussion with your doctor about your symptoms. She may want to adjust your dosage or have you quit or switch the supplement you’re taking. If it reduces the number of migraine attacks you suffer by half, you know you’re on the right track.