In our previous article we have talked about essential oils in alleviating migraine headache. Here we are going for nutritional as well as herbal approach. Many people prefer dietary supplementation over medications as more natural approaches. And I feel happy to inform that many researches have found significant evidences in relieving migraine pain with supplementation of vitamins, minerals and herbs. It is important to understand these vitamins, supplements or herbs about their nature, use, proven evidences of prevention of migraine, benefits and potential effects.
Riboflavin (Vitamin B2)
Vitamin B2 of Riboflavin has many health beneficial effects such as such as maintaining healthy blood cells, helping to boost energy levels by converting food into energy, working as antioxidant preventing from damaging particles in the body called as free radical, contributing to growth, maintaining healthy mitochondrial metabolism, and more. (1)Food sources of riboflavin includes milk, egg, green vegetable, meat etc.
There are numbers of studies regarding Vitamin B2 and migraine relieves and found Vitamin B2 or Riboflavin supplementation is beneficial to reduce frequency of migraine attack and duration but not intensity in majority.
In a pharmacogenetic study conducted by researcher, 400mg of riboflavin taken daily over the course of four months, appeared to beneficial to majority of the group of people(40 out of 60) having migraine.(2)
In a another study to investigate the efficacy of riboflavin for the prevention of migraine, revealed that supplementation of riboflavin 400 mg daily for three months reduce migraine frequency significantly and shorten the duration, but not intensity. It is shown to be safe and well tolerated remedy for migraine headache. ( 3 4 )
Riboflavin supplementation likely safe for most of the people. Small numbers of people experience diarrhea and increased urine, while taking high doses. If is usually safe for pregnant and breastfeeding women, however before taking high doses, should consult with physician. Interactions of Riboflavin with other medication are known as minor. However you should consult with physician if you are under medication. Consumption of alcoholic beverage or smoking lowers the effect of Riboflavin.
Magnesium is an abundant mineral in human body which has many important functions. It is co factor in more than 300 enzyme system that regulates biochemical reactions in the body including protein formation, blood pressure regulation, muscle and nerve function and blood glucose level. Magnesium plays an important rule in energy production and in a process of active transport of calcium and potassium ions across cell membranes, which is important to nerve impulse conduction, muscle contraction, and normal heart rhythm.(5)Magnesium helps muscle to relax and contract. And thus magnesium deficiency can lead to pain related disorder.
People suffering from migraines are more prone to have magnesium deficiency than other people. Oral magnesium is extremely safe, cost effective and for patients who are magnesium deficient can be highly effective. (6)
There are several studies related to migraine headache and magnesium. In a double blind, randomized, placebo controlled study, researcher found that magnesium supplementation of 600mg/day significantly reduced migraine severity.(7)
Magnesium supplementation is likely safe, however pregnant and breastfeeding women, people with under treatment of antibiotic or under special condition or treatment consult with healthcare provider first. In some people, taking too much doses may cause laxative effect, stomach upset, nausea, vomiting or diarrhea. Hence should not go overdoses. People with migraine attack have to take at about 400mg/day for three month to see the results.(8)
Coenzyme Q10 (CoQ10)
Coenzyme Q10 is a substance of ubiquinone family and found in almost every cell of body. Cells of human body require it for energy production and growth and maintenance. CoQ10 also acts as antioxidant to protect your body cells from harmful free radicals. Coenzyme Q10 also acts as co enzyme to digest food and helps in performing other body processes. Human body make Coenzyme Q10 naturally but deficiency may occur due to low dietary intake, disease or high utilization by the body.(9) Production of CoQ10 in body declines as we go older and feel lack of energy. So, your body needs dietary approaches to maintain the level. Food source of CoQ10 are herring, sardine, mackerel, broccoli, orange, nuts, pasture raised egg, strawberries etc.
Researcher found that supplementation of CoQ10 in migraine prevention is efficacious and well tolerated.(10)A study on efficacy of coenzyme Q10 as a preventative treatment for migraine with 32 patients (both women and men) with a history of episodic migraine with or without aura were treated with coenzyme Q10 at a dose of 150 mg per day for a period of three months results migraine attack frequency was significantly reduced after end of the period of three months and no side effects was observed with CoQ10. (11)
In a recent open-label, parallel, add-on, match-controlled trial study on adults with 100mg CoQ10 daily with patient current preventive drugs matching their baseline characteristics, found that there was significant reduction in numbers of attacks and also decrease severity of headaches. The study suggests that CoQ10 might reduce the frequency of headaches and may also shorten the duration and make less severe. The study also reported that it has a favorable safety profile.(12)
CoQ10 supplementation is likely safe. However some people may experience nausea, vomiting and diarrhea with high dose. It is also found as safe for pregnant and breastfeeding women as well. However they and people with specific health condition should consult with healthcare provider first. It may interact with cancer medication, blood pressure lowering drug (Coenzyme Q-10 seems to lower blood pressure) and Warfarin (Coumadin) used to slow blood clotting. For, prevention of migraine CoQ10 supplementation can be taken 100mg two to three times daily by adults.(13, 14)
Feverfew is an herb belongs to daisy family, traditionally used for treatment of fever, so the name called. Historically feverfew was using as herbal remedies for fevers, headaches, constipation, diarrhea, difficulty in labor, and dizziness. In Today, feverfew is used as a dietary supplement as remedies for numbers of health alignments. Such alignments include migraine pain, problems with menstruation, rheumatoid arthritis, psoriasis, allergies, asthma, tinnitus (ringing or roaring sounds in the ears), dizziness, nausea, vomiting, and for intestinal parasites.(15)
The efficacy of feverfew in migraine treatment has mixed results. Some believe that feverfew appears to be effective in reducing migraine.
As per study of University of Maryland Medical Center, on 270 people with migraines, found that more than 70% of them felt much better after taking an average of 2 to 3 fresh feverfew leaves daily.(16) In a systematic review done by Department of Complementary Medicine, School of Postgraduate Medicine and Health Science, University of Exeter, UK, found that feverfew is likely to be effective in the prevention of migraine and it poses no major safety problems.(17)
In most cases supplement manufacturers use dried feverfew leaves as ingredient of supplement.
Butterbur or Petasites hybridus is a a shrub that grows in Europe, parts of Asia including Korea, China and Japan and North America, typically in wet, marshy ground. Over many centuries, peoples are using leaf, root and bulb of butterbur to treat variety of alignments including removing pain, stomach upset, headache, fever, cough, sleeping trouble, wound healing and more.
In recent studies researchers found that butterbur has promising remedial effect to migraine. Some species of butterbur contains petasin and isopetasin as active compound and believed to be effective in preventing and relieving migraine. Petasin cause smooth muscular and vascular wall relaxation.(18)
In a study of randomised, placebo-controlled parallel-group as published in European Neeurology, with application of butterbur 25mg twice a day for three months, researchers found that butterbur is well tolerated and may be effective in treatment of migraine.(19)
In an another study published in The Official Journal of American Academy of Neurology, on three arm parallel group, 245 patients of migraine with at least two to six attacks per month over the preceding 3 months (ages from 16 to 65 years) revealed that taking 75mg of butterbur twice a day for four month, significantly reduced migraine attack and well tolerated for prevention of migraine.(20)
In a another study in children and adolescents (with age from 6 to 17) with severe migraines, treated with 50mg to 150mg of butterbur root extract depending on age for a period of 4months found that there was significant reduction in migraine attack frequency in majority and well-tolerated migraine prophylaxis also for children and teenagers. No serious adverse events occurred.(21)
Butterbur plant itself contains pyrrolizidine alkaloids or PA. While selecting butterbur herbal preparation or products it should be kept in mind that it does not contain PA (pyrrolizidine alkaloids or PA can be harmful to liver).These substances are removed in the commercially available preparations, such as those manufactured by Weber & Weber (Inning am Ammersee, Germany; Petadolex® and others). In studies, Petadolex® was found as well tolerated and no serious adverse events observed. The most frequently reported adverse reactions were mild gastrointestinal events, especially eructation (burping). Like most other herbal preparations, pregnant or breastfeeding women and person with specific health condition or under treatment should consult with physician first before taking supplementation.(22)
A specific butterbur root extract (Petadolex, Weber&Weber, GmbH & Co, Germany) can be used in doses of 50 to 100 mg twice daily with meals for 4-6 months to prevent migraine headache. Lower doses of 50 mg twice daily may not be effective in adults.(23)
Combination of supplements for preventing migraine:
A study on 130 adult with migraine attack (age 18 – 65 years) as published in The Journal of Headache and Pain in 2015, found reduction of migraine pain and burden of disease with 3 months supplementation of a daily dose of 600 mg magnesium, 400 mg riboflavin and 150 mg Q10. Side effects like abdominal discomfort and diarrhea were associated with the supplementation of mainly due to higher doses of magnesium. The study has not reported any adverse effect.(24)
The Journal of BMC Complementary and Alternative Medicine has published a recent research study in Aug. 2017 on of supplementation of combination of 100 mg feverfew, 100 mg coenzyme Q10 and 112.5 mg magnesium per day for 3 months. The studies concluded that proprietary supplement of feverfew, coenzyme Q10 and magnesium could be beneficial and safe for the prevention of migraine in adult patients. (25)
Different vitamins, herbs, and minerals may helps in relieving migraine pain. You should also know that migraine triggering factors may vary person to person. And so different people may get benefits in different way.
Some essential oils and some other preventive measures work well in relieving migraine headache. You can also read Natural home remedies for relieving migraine headache and common migraine triggering factors.
Disclaimer: Information provided here are generalized information for educational purpose only, not intended to provide one to one health consultation or replace practice of a qualified practitioner. Different people may have different health condition and may have different reaction to the same food. Hence it has been advised to consult with health care provider before application of any of above guidelines.
Source and reference: 1. http://www.umm.edu/health/medical/altmed/supplement/vitamin-b2- riboflavin 2. https://www.ncbi.nlm.nih.gov/pubmed/19414726 3. https://www.ncbi.nlm.nih.gov/pubmed/28485121 4. https://www.ncbi.nlm.nih.gov/pubmed/15257686 5. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ 6. https://www.ncbi.nlm.nih.gov/pubmed/22426836 7. https://www.ncbi.nlm.nih.gov/pubmed/18705538 8. https://www.webmd.com/migraines-headaches/vitamins-supplements- migraines#1 9. http://www.mayoclinic.org/drugs-supplements/coenzyme-q10/evidence/hrb- 20059019 10. http://www.neurology.org/content/64/4/713 11. https://www.ncbi.nlm.nih.gov/pubmed/11972582 12. https://www.ncbi.nlm.nih.gov/pubmed/27670440 13. https://www.webmd.com/vitamins-supplements/ingredientmono-938- Coenzyme+Q10+COENZYME+Q-10.aspx activeIngredientId=938&activeIngredientName=Coenzyme+Q10+(COENZYME+Q- 10)&source=2 14. https://www.mayoclinic.org/drugs-supplements/coenzyme-q10/dosing/hrb- 20059019 15. https://nccih.nih.gov/health/feverfew 16. http://www.umm.edu/health/medical/altmed/herb/feverfew 17. https://www.ncbi.nlm.nih.gov/pubmed/11276299 18. http://onlinelibrary.wiley.com/doi/10.1111/j.1526- 4610.2011.01846.x/full 19. https://www.ncbi.nlm.nih.gov/pubmed/14752215 20. http://www.neurology.org/content/63/12/2240 21. https://www.ncbi.nlm.nih.gov/pubmed/15836592 22. http://onlinelibrary.wiley.com/doi/10.1111/j.1526- 4610.2011.01846.x/full 23. https://www.webmd.com/vitamins-supplements/ingredientmono-649- butterbur.aspx?activeingredientid=649&activeingredientname=butterbur 24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393401/ 25.https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906 -017-1933-7