Migraine headaches are a common concern, significantly impacting quality of life for the sufferer, as well as work and social function. For many people that experience migraines, the response to pharmacologic management may be incomplete. Because of this, there is a strong need for additional supportive strategies in these individuals. Removal of individual dietary triggers is a useful strategy for many people with migraines. Nutritional supplements and botanical medicines (or phytonutrients) that may be considered include magnesium, riboflavin, alpha lipoic acid, coenzyme Q10, feverfew, curcumin, and butterbur.
Get full access to this article
View all access options for this article.
References
1.
PetersGL. Migraine overview and summary of current and emerging treatment options. Am J Manag Care, 2019; 25:S23–S34.
2.
WoldeamanuelYW, CowanRP. Migraine affects 1 in 10 people worldwide featuring recent rise: A systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci, 2017; 372:307–315.
3.
PeresMFP, MercanteJPP, ToboPR, et al.Anxiety and depression symptoms and migraine: A symptom-based approach research. J Headache Pain, 2017; 18:37.
4.
BuseDC, ManackA, SerranoD, et al.Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. J Neurol Neurosurg Psychiatry, 2010; 81:428–432.
5.
PopitM, Zaletel-KrageljL, ErženI, et al.Estimation of the impact of migraine on self-rated health: A cross-sectional study in Slovenia. Slov J Public Heal, 2021; 60:38.
6.
DolatiS, RikhtegarR, MehdizadehA, et al.The role of magnesium in pathophysiology and migraine treatment. Biol Trace Elem Res, 2020; 196:375–383.
7.
KursunO, YemisciM, van den MaagdenbergAMJM, et al.Migraine and neuroinflammation: The inflammasome perspective. J Headache Pain, 2021; 22:1–13.
AndreouAP, EdvinssonL. Mechanisms of migraine as a chronic evolutive condition. J Headache Pain, 2019; 20:1–17.
10.
GoschorskaM, GutowskaI, Baranowska-bosiackaI, et al.The use of antioxidants in the treatment of migraine. Antioxidants, 2020; 9:116.
11.
RaineroI, VaccaA, RovetaF, et al.Targeting MTHFR for the treatment of migraines. Expert Opin Ther Targets, 2019; 23:29–37.
12.
AilaniJ, BurchRC, RobbinsMS. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache J Head Face Pain, 2021; 61:1021–1039.
13.
AdamsJ, BarberyG, LuiCW. Complementary and alternative medicine use for headache and migraine: A critical review of the literature. Headache, 2013; 53:459–473.
14.
BaeJ, SungH-K, KwonN-Y, et al.Cognitive behavioral therapy for migraine headache: A systematic review and meta-analysis. Medicina (B Aires), 2021; 58:44.
15.
WellsRE, SengEK, EdwardsRR, et al.Mindfulness in migraine: A narrative review. Expert Rev Neurother, 2020; 20:207–225.
16.
BarberM, PaceA. Exercise and migraine prevention: A review of the literature. Curr Pain Headache Rep, 2020; 24:39.
17.
LindeK, AllaisG, BrinkhausB, et al.Acupuncture for migraine prophylaxis. Cochrane Database Syst Rev, 2009; 1:CD001218.
18.
GriauzdaitėK, MaselisK, ŽvirblienėA, et al.Associations between migraine, celiac disease, non-celiac gluten sensitivity and activity of diamine oxidase. Med Hypotheses, 2020; 142:109738.
19.
GazeraniP. Migraine and diet. Nutrients, 2020; 12:1–11.
20.
MitchellN, HewittCE, JayakodyS, et al.Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches. Nutr J, 2011; 10:1–9.
21.
AlpayK, ErtaM, OrhanEK, et al.Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial. Cephalalgia, 2010; 30:829–837.
22.
Arroyave HernándezCM, Echevarría PintoM, Hernández MontielHL. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex, 2007; 54:162–168.
23.
ReesT, WatsonD, LipscombeS, et al.A prospective audit of food intolerance among migraine patients in primary care clinical practice. Headache Care, 2005; 2:11–14.
24.
AydinlarEI, DikmenPY, TiftikciA, et al.IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache, 2013; 53:514–525.
25.
Van HemertS, BreedveldAC, RoversJ, et al.Migraine associated with gastrointestinal disorders: Review of the literature and clinical implications. Front Neurol, 2014; 5:241.
26.
GrossEC, PutananickalN, OrsiniAL, et al.Mitochondrial function and oxidative stress markers in higher-frequency episodic migraine. Sci Reports, 2021; 11:1–12.
27.
Rivera-MancillaE, Al-HassanyL, VillalónCM, et al.Metabolic aspects of migraine: Association with obesity and diabetes mellitus. Front Neurol, 2021; 12:686398.
28.
BerneckerC, PailerS, KieslingerP, et al.GLP-2 and leptin are associated with hyperinsulinemia in non-obese female migraineurs. Cephalalgia, 2010; 30:1366–1374.
29.
StreelS, DonneauAF, DardenneN, et al.Screening for the metabolic syndrome in subjects with migraine. Cephalalgia, 2017; 37:1180–1188.
30.
SivaZO, UluduzD, KeskinFE, et al.Determinants of glucose metabolism and the role of NPY in the progression of insulin resistance in chronic migraine. Cephalalgia, 2018; 38:1773–1781.
31.
SunWW, ZhuP, ShiYC, et al.Current views on neuropeptide y and diabetes-related atherosclerosis. Diabetes Vasc Dis Res, 2017; 14:277–284.
32.
OliveiraMM, AkermanS, TavaresI, et al.Neuropeptide Y inhibits the trigeminovascular pathway through NPY Y1 receptor: Implications for migraine. Pain, 2016; 157:1666.
33.
Di LorenzoC, CoppolaG, BracagliaM, et al.Cortical functional correlates of responsiveness to short-lasting preventive intervention with ketogenic diet in migraine: A multimodal evoked potentials study. J Headache Pain, 2016; 17:58.
34.
YuanX, WangJ, YangS, et al.Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: A systematic review and meta-analysis. Nutr Diabetes, 2020; 10:38.
35.
PaoliA, MancinL, GiaconaMC, et al.Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med 2020 181, 2020; 18:1–11.
36.
SlavinM, LiH, FrankenfeldC, et al.What is needed for evidence-based dietary recommendations for migraine: A call to action for nutrition and microbiome research. Headache, 2019; 59:1566–1581.
37.
SchwalfenbergGK, GenuisSJ. The importance of magnesium in clinical healthcare. Scientifica (Cairo), 2017; 2017:4179326.
38.
QaswalAB. Magnesium ions depolarize the neuronal membrane via quantum tunneling through the closed channels. Quantum Reports, 2020; 2:57–63.
PringsheimT, DavenportW, MackieG, WorthingtonI, AubeM, ChristieSN, Gladstone JBW. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci, 2012; 39:S1–S59.
41.
PeikertA, WilimzigC, Köhne-VollandR. Prophylaxis of migraine with oral magnesium: Results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia, 1996; 16:257–263.
42.
KöseogluE, TalasliogluA, GönülAS, et al.The effects of magnesium prophylaxis in migraine without aura. Magnes Res, 2008; 21:101–108.
43.
FacchinettiF, SancesG, BorellaP, et al.Magnesium prophylaxis of menstrual migraine: Effects on intracellular magnesium. Headache J Head Face Pain, 1991; 31:298–301.
44.
MahabadiN, BhusalA, BanksSW. Riboflavin deficiency. Br Med J, 2021; 2:678.
45.
NamaziN, HeshmatiJ, Tarighat-EsfanjaniA. Supplementation with riboflavin (vitamin B2) for migraine prophylaxis in adults and children: A review. Int J Vitam Nutr Res, 2015; 85:79–87.
46.
ThompsonDF, SalujaHS. Prophylaxis of migraine headaches with riboflavin: A systematic review. J Clin Pharm Ther, 2017; 42:394–403.
47.
HoffmanMR, AltheimerA. Is riboflavin effective for migraine prophylaxis?. Evidence-Based Pract, 2020; 23:36.
48.
SalehiB, Berkay YılmazY, AntikaG, et al.Insights on the use of α-lipoic acid for therapeutic purposes. Biomolecules, 2019; 9:356.
49.
ChoiKH, ParkMS, KimHS, et al.Alpha-lipoic acid treatment is neurorestorative and promotes functional recovery after stroke in rats. Mol Brain, 2015; 8:1–16.
50.
MagisD, AmbrosiniA, SándorP, et al.A randomized double-blind placebo-controlled trial of thioctic acid in migraine prophylaxis. Headache, 2007; 47:52–57.
51.
Rezaei KelishadiM, Alavi NaeiniA, AskariG, et al.The efficacy of alpha-lipoic acid in improving oxidative, inflammatory, and mood status in women with episodic migraine in a randomised, double-blind, placebo-controlled clinical trial. Int J Clin Pract, 2021; 75:e14455.
52.
CavestroC, BedogniG, MolinariF, et al.Alpha-lipoic acid shows promise to improve migraine in patients with insulin resistance: A 6-month exploratory study. J Med Food, 2018; 21:269–273.
53.
ShoeibiA, OlfatiN, Soltani SabiM, et al.Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: An open-label, add-on, controlled trial. Acta Neurol Belg, 2017; 117:103–109.
54.
HersheyAD, PowersSW, VockellALB, et al.Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache, 2007; 47:73–80.
55.
RozenTD, OshinskyML, GebelineCA, et al.Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia, 2002; 22:137–141.
56.
SândorPS, Di ClementeL, CoppolaG, et al.Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology, 2005; 64:713–715.
57.
DahriM, Tarighat-EsfanjaniA, Asghari-JafarabadiM, et al.Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers. Nutr Neurosci, 2019; 22:607–615.
58.
AnsariM, KhR, YasaN, et al.Measurement of melatonin in alcoholic and hot water extracts of Tanacetum parthenium, Tripleurospermum disciforme and Viola odorata. DARU J Pharm Sci, 2010; 18:173.
59.
MurphyJJ, HeptinstallS, MitchellJRA. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet, 1988; 332:189–192.
60.
PfaffenrathV, DienerHC, FischerM, et al.The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis—A double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia, 2002; 22:523–532.
61.
DienerHC, PfaffenrathV, SchnitkerJ, et al. Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention—A randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia, 2005; 25:1031–1041.
62.
AskarizadehA, BarretoGE, HenneyNC, et al.Neuroprotection by curcumin: A review on brain delivery strategies. Int J Pharm, 2020; 585:119476.
63.
DjalaliM, AbdolahiM, HosseiniR, et al.The effects of nano-curcumin supplementation on Th1/Th17 balance in migraine patients: A randomized controlled clinical trial. Complement Ther Clin Pract, 2020; 41:101256.
64.
AbdolahiM, KarimiE, SarrafP, et al.The omega-3 and Nano-curcumin effects on vascular cell adhesion molecule (VCAM) in episodic migraine patients: A randomized clinical trial. BMC Res Notes, 2021; 14:283.
65.
AbdolahiM, TafakhoriA, ToghaM, et al.The synergistic effects of ω-3 fatty acids and nano-curcumin supplementation on tumor necrosis factor (TNF)-α gene expression and serum level in migraine patients. Immunogenetics, 2017; 69:371–378.
66.
SoveydN, AbdolahiM, DjalaliM, et al.The combined effects of ω-3 fatty acids and nano-curcumin supplementation on intercellular adhesion molecule-1 (ICAM-1) gene expression and serum levels in migraine patients. CNS Neurol Disord Drug Targets, 2017; 16:1120–1126.
67.
AbdolahiM, SarrafP, JavanbakhtMH, et al.A novel combination of ω-3 fatty acids and nano-curcumin modulates interleukin-6 gene expression and high sensitivity C-reactive protein serum levels in patients with migraine: A randomized clinical trial study. CNS Neurol Disord Drug Targets, 2018; 17:430–438.
68.
HonarvarNM, SoveidN, AbdolahiM, et al.Anti-neuroinflammatory properties of n-3 fatty acids and nano-curcumin on migraine patients from cellular to clinical insight: A randomized, double-blind and placebo-controlled trial. Endocrine Metab Immune Disord Drug Targets, 2020; 21:365–373.
69.
AbdolahiM, JafariehA, SarrafP, et al.The neuromodulatory effects of ω-3 fatty acids and nano-curcumin on the COX-2/iNOS network in migraines: A clinical trial study from gene expression to clinical symptoms. Endocrine Metab Immune Disord Drug Targets, 2019; 19:874–884.
70.
KisieliusV, HamaJR, SkrbicN, et al.The invasive butterbur contaminates stream and seepage water in groundwater wells with toxic pyrrolizidine alkaloids. Sci Rep, 2020; 10:19784.
71.
GrossmannM, SchmidramslH. An extract of Petasites hybridus is effective in the prophylaxis of migraine. Int J Clin Pharmacol Ther, 2000; 38:430–435.
72.
DienerHC, RahlfsVW, DaneschU. The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: Reanalysis of efficacy riteria. Eur Neurol, 2004; 51:89–97.
73.
LiptonRB, GöbelH, EinhäuplKM, et al.Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology, 2004; 63:2240–2244.
74.
PothmannR, DaneschU. Migraine prevention in children and adolescents: Results of an open study with a special butterbur root extract. Headache, 2005; 45:196–203.
DaneschU, RittinghausenR. Safety of a patented special butterbur root extract for migraine prevention. Headache, 2003; 43:76–78.
77.
BuseDC, RupnowMFT, LiptonRB. Assessing and managing all aspects of migraine: Migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc, 2009; 84:422–435.
