Migraine Headache - Supplements

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What Are "Star" Ratings?

a7_3star Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

Supplement	Amount	Why
Butterbur	Adults: 75 mg twice a day of an extract standardized to contain at least 15% petasins; children: reduce amount according to body weight	Butterbur extract has been should to significantly reduce the frequency of migraine attacks.
Butterbur Adults: 75 mg twice a day of an extract standardized to contain at least 15% petasins; children: reduce amount according to body weight Double-blind trials have demonstrated that butterbur extract can reduce the frequency of migraine attacks significantly better than placebo.³⁷ ^{, 38} One study has also shown it helps reduce the frequency of migraine headaches in children and adolescents, though there was no control group so it is not as clear just how effective butterbur extract is in this population.³⁹ In a double-blind trial, supplementing with an extract of butterbur (Petasites hybridus) for four months was significantly more effective than a placebo at reducing the frequency of migraine attacks.⁴⁰ The amount of butterbur found to be effective was 75 mg twice a day of an extract standardized to contain at least 15% petasins. A smaller amount (50 mg twice a day) was ineffective. The most common side effect was burping. What Else Is This Supplement Used For?

Supplement	Amount	Why
Feverfew	Standardized herbal extract delivering 250 mcg of parthenolide per day	Feverfew is the most frequently used herb for the long-term migraine prevention. Continuous use of feverfew may reduce the severity, duration, and frequency of migraine headaches.
Feverfew Standardized herbal extract delivering 250 mcg of parthenolide per day The most frequently used herb for the long-term prevention of migraines is feverfew.⁴¹ Four double-blind trials have reported that continuous use of feverfew leads to a reduction in the severity, duration, and frequency of migraine headaches,⁴² ^{, 43} ^{, 44} ^{, 45} although one double-blind trial found feverfew to be ineffective.⁴⁶ Studies suggest that taking standardized feverfew leaf extracts that supply a minimum of 250 mcg of parthenolide per day is most effective. Results may not be evident for at least four to six weeks. Although there has been recent debate about the relevance of parthenolide as an active constituent,⁴⁷ it is best to use standardized extracts of feverfew until research proves otherwise. What Else Is This Supplement Used For?

Supplement	Amount	Why
Magnesium	360 to 600 mg daily	Compared with healthy people, migraine sufferers have been found to have lower magnesium levels. Supplementing with magnesium may reduce migraine frequency and relieve symptoms.
Magnesium 360 to 600 mg daily Compared with healthy people, people with migraines have been found to have lower blood and brain levels of magnesium.⁴⁸ ^{, 49} ^{, 50} ^{, 51} Preliminary research in a group of women (mostly premenopausal) showed that supplementing with magnesium (usually 200 mg per day) reduced the frequency of migraines in 80% of those treated.⁵² In a double-blind trial of 81 people with migraines, 600 mg of magnesium per day was significantly more effective than placebo at reducing the frequency of migraines.⁵³ Another double-blind trial found that taking 360 mg of magnesium per day decreased the number of days on which premenstrual migraines occurred.⁵⁴ One double-blind trial found no benefit from 486 mg of magnesium per day for three months. However, that study defined improvement according to extremely strict criteria, and even some known anti-migraine drugs have failed to show benefit when tested using those criteria.⁵⁵ Intravenous magnesium has been reported to produce marked and sometimes complete symptom relief during acute migraines, usually within 15 minutes or less.⁵⁶ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin B2 (For adults only )	400 mg daily	Studies have shown vitamin B2 to be effective at reducing the frequency and severity of migraine headaches.
Vitamin B2 400 mg daily One group of researchers treated 49 migraine patients with large amounts of vitamin B2 (400 mg per day). Both the frequency and severity of migraines decreased by more than two-thirds.⁵⁷ In a follow-up three-month, double-blind trial, the same researchers reported that 59% of patients assigned to receive vitamin B2 had at least a 50% reduction in the number of headache days, whereas only 15% of those assigned to receive a placebo experienced that degree of improvement.⁵⁸ The effects of vitamin B2 were most pronounced during the final month of the trial.⁵⁹ In a preliminary study, a much smaller amount of vitamin B2 (25 mg per day for three months) reduced the frequency of migraines by about one-third in chronic migraine sufferers.⁶⁰ All of the studies that found riboflavin to be effective for preventing migraine were conducted in adults. In a double-blind trial, supplementation with 200 mg per day of riboflavin did not decrease the frequency or severity of migraines in children whose average age was 11 years.⁶¹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
5-HTP	200 to 600 mg daily for adults, 20 mg for every 10 pounds of body weight for children	Several studies have found 5-HTP to be effective at reducing the frequency, severity, and duration of migraine headaches.
5-HTP 200 to 600 mg daily for adults, 20 mg for every 10 pounds of body weight for children The cause of migraine headache is believed to be related to abnormal serotonin function in blood vessels,⁶² and 5-HTP (5-hydroxytryptophan, which is converted by the body into serotonin) may affect this abnormality. In one study, 40 people with recurrent migraines received either 5-HTP (200 mg per day) or methysergide (a drug used to prevent migraines) for 40 days. Both compounds reduced the frequency of migraines by about 50%.⁶³ Larger amounts of 5-HTP (600 mg per day) were also found to be as effective as medications for reducing migraine headache attacks in adults in two double-blind trials.⁶⁴ ^{, 65} Migraine attacks were reduced in frequency, severity, and duration in 90% of those taking 400 mg per day of 5-HTP in a double-blind placebo-controlled trial,⁶⁶ though another trial found no benefit of 5-HTP.⁶⁷ In another controlled study, 400 mg of dl-5-HTP (another form of 5-HTP) led to reduced consumption of pain-killing drugs and pain scores after one to two months.⁶⁸ Children who suffered from migraines and had problems sleeping responded well to a daily amount of 5-HTP equal to 20 mg for every 10 pounds of body weight in a controlled trial,⁶⁹ though an earlier study showed 5-HTP had no better effect than placebo for children with migraines.⁷⁰ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Alpha Lipoic Acid	600 mg per day	In a small double-blind trial, supplementing with alpha-lipoic acid significantly reduced the frequency of migraine attacks.
Alpha Lipoic Acid 600 mg per day In a small double-blind trial, supplementation with 600 mg of alpha-lipoic acid once a day for three months significantly reduced the frequency of migraine attacks. However, this improvement was not statistically significant when compared with the change in the placebo group.⁷¹ Additional research is needed to determine whether alpha-lipoic acid is effective for preventing migraines. What Else Is This Supplement Used For?

Supplement	Amount	Why
Butterbur (Adolescents, Children)	Refer to label instructions	One study has shown that butterbur helps reduce the frequency of migraine headaches in children and adolescents.
Butterbur Double-blind trials have demonstrated that butterbur extract can reduce the frequency of migraine attacks significantly better than placebo.⁷² ^{, 73} One study has also shown it helps reduce the frequency of migraine headaches in children and adolescents, though there was no control group so it is not as clear just how effective butterbur extract is in this population.⁷⁴ In a double-blind trial, supplementing with an extract of butterbur (Petasites hybridus) for four months was significantly more effective than a placebo at reducing the frequency of migraine attacks.⁷⁵ The amount of butterbur found to be effective was 75 mg BID of an extract standardized to contain at least 15% petasins. A smaller amount (50 mg BID) was ineffective. The most common side effect was burping. What Else Is This Supplement Used For?

Supplement	Amount	Why
Coenzyme Q10	100 to 150 mg daily	In a preliminary trial, supplementation with coenzyme Q10 for three months reduced the average number of days with migraine headaches by 60%.
Coenzyme Q10 100 to 150 mg daily Blood levels of coenzyme Q10 have been found to be low in about one-third of migraine sufferers.⁷⁶ In a preliminary trial, supplementation of migraine sufferers with 150 mg per day of coenzyme Q10 for three months reduced the average number of days with migraine headaches by 60%.⁷⁷ The beneficial effect of coenzyme Q10 was confirmed in a four-month double-blind study. By the fourth month of treatment, a reduction in migraine frequency of 50% or greater occurred in 47.6% of people receiving 100 mg of coenzyme Q10 three times a day, but in only 14.4% of those receiving a placebo (a statistically significant difference).⁷⁸ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Folic Acid (For a subset of people )	5 mg per day	Taking folic acid may improve migraines in people with high homocysteine levels and a certain genetic characteristic.
Folic Acid 5 mg per day In a preliminary trial, supplementation with 5 mg of folic acid per day for six months completely eliminated recurrent migraine attacks in 10 of 16 children and reduced the number of attacks by 50 to 75% in the other six children. The children selected to be in this study had elevated homocysteine levels (which can be reduced by folic acid supplementation), as well as a certain genetic characteristic known as a polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene.⁷⁹ Further research is needed to determine whether folic acid supplementation would be beneficial for migraine patients who do not have these specific characteristics. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin B12	1 mg daily	In a preliminary trial, vitamin B12 reduced the frequency of migraine attacks by at least 50% in 10 of 19 people with recurrent migraines.
Vitamin B12 1 mg daily In a preliminary trial, administration of 1 mg of vitamin B12 per day (by the intranasal route) for 3 months reduced the frequency of migraine attacks by at least 50% in 10 of 19 people with recurrent migraines.⁸⁰ A placebo-controlled study is needed to determine how much of this improvement was due to a placebo effect. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Calcium	Refer to label instructions	Taking large amounts of the combination of calcium and vitamin D has been reported to produce a marked reduction in the incidence of migraines in several women.
Calcium Caution: Calcium supplements should be avoided by prostate cancer patients. Taking large amounts of the combination of calcium (1,000 to 2,000 mg per day) and vitamin D has been reported to produce a marked reduction in the incidence of migraines in several women.⁸¹ ^{, 82} However, the amount of vitamin D given to these women (usually 50,000 IU once a week), can cause adverse reactions, particularly when used in combination with calcium. This amount of vitamin D should be used only under medical supervision. Doctors often recommend that people take 800 to 1,200 mg of calcium and 400 IU of vitamin D per day. However, it is not known whether theses amounts would have an effect on migraines. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Cayenne	Refer to label instructions	Capsaicin, the active constituent of cayenne, may be applied inside the nose as a treatment for acute migraine under a doctor’s supervision.
Cayenne There is preliminary evidence that capsaicin, the active constituent of cayenne, can be applied inside the nose as a treatment for acute migraine.⁸³ However, as intranasal application of capsaicin produces a burning sensation, it should be used only under the supervision of a doctor familiar with its use. What Else Is This Supplement Used For?

Supplement	Amount	Why
Fish Oil	Refer to label instructions	Fish oil containing EPA and DHA has been reported to reduce migraine headache symptoms. Fish oil may help because of its effects in modifying hormone-like substances called prostaglandins.
Fish Oil Fish oil containing EPA and DHA has been reported to reduce the symptoms of migraine headache in a double-blind trial using 1 gram of fish oil per 10 pounds of body weight.⁸⁴^{, 85} Fish oil may help because of its effects in modifying prostaglandins (hormone-like substances made by the body). What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Ginger	Refer to label instructions	Anecdotal evidence suggests ginger may be used for migraines and the accompanying nausea.
Ginger Anecdotal evidence suggests ginger may be used for migraines and the accompanying nausea.⁸⁶ What Else Is This Supplement Used For?

Supplement	Amount	Why
Ginkgo	Refer to label instructions	Ginkgo extract may also help because it inhibits the action of a substance known as platelet-activating factor, which may contribute to migraines.
Ginkgo Ginkgo biloba extract may also help because it inhibits the action of a substance known as platelet-activating factor,⁸⁷ which may contribute to migraines. No clinical trials have examined its effectiveness in treating migraines, however. What Else Is This Supplement Used For?

Supplement	Amount	Why
L-Tryptophan	Refer to label instructions	Preliminary research has found abnormally low levels of serotonin in the brains of people suffering a migraine attack, which was reversed with L-tryptophan supplements.
L-Tryptophan Interest in the effects of serotonin on the mechanisms of migraine has led to therapeutic trials using serotonin precursors such as L-tryptophan and 5-hydroxytryptophan (5-HTP).⁸⁸ Preliminary research has found abnormally low levels of serotonin in the brains of people suffering a migraine attack, which was reversed with L-tryptophan supplements.⁸⁹ A small double-blind trial found that four of eight people had fewer and less intense migraines while receiving L-tryptophan (500 mg every six hours).⁹⁰ Larger double-blind trials are needed to better evaluate L-tryptophan as a migraine prevention supplement. In one study, 40 people with recurrent migraines received either 5-HTP (200 mg per day) or methysergide (a drug used to prevent migraines) for 40 days. Both compounds reduced the frequency of migraines by about 50%.⁹¹ Larger amounts of 5-HTP (600 mg per day) were also found to be as effective as medications for reducing migraine headache attacks in adults in two double-blind trials.⁹² ^{, 93} Migraine attacks were reduced in frequency, severity, and duration in 90% of those taking 400 mg per day of 5-HTP in a double-blind placebo-controlled trial,⁹⁴ though another trial found no benefit of 5-HTP.⁹⁵ In another controlled study, 400 mg per day of DL-5-HTP (another form of 5-HTP, equivalent to 200 mg per day of 5-HTP per day led to reduced consumption of pain-killing drugs and pain scores after one to two months.⁹⁶ Children who suffered from migraines and had problems sleeping had an improvement in both migraines and sleep disorders after taking 5-HTP in the amount of 20 mg for every 10 pounds of body weight in a controlled trial,⁹⁷ though an earlier study showed 5-HTP had no better effect than placebo for children with migraines.⁹⁸ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Melatonin	Refer to label instructions	Pineal gland function and melatonin secretion may be disturbed in people with migraine headaches. Taking melatonin may correct this problem and reduce symptoms.
Melatonin The function of the pineal gland and its cyclic secretion of melatonin may be disturbed in people with migraine headaches.⁹⁹ Preliminary evidence suggests that 5 mg per day of melatonin, taken 30 minutes before bedtime, may reduce symptoms of migraine headache.¹⁰⁰ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
SAMe	Refer to label instructions	Preliminary research suggests that supplementing with SAMe may reduce symptoms for some migraine sufferers.
SAMe Preliminary research also suggests that oral supplements of SAMe (S-adenosyl-L-methionine) may reduce symptoms for some migraine sufferers.¹⁰¹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin D	Refer to label instructions	Taking large amounts of the combination of calcium and vitamin D has been reported to produce a marked reduction in the incidence of migraines in several women.
Vitamin D Taking large amounts of the combination of calcium (1,000 to 2,000 mg per day) and vitamin D has been reported to produce a marked reduction in the incidence of migraines in several women.¹⁰² ^{, 103} However, the amount of vitamin D given to these women (usually 50,000 IU once a week), can cause adverse reactions, particularly when used in combination with calcium. This amount of vitamin D should be used only under medical supervision. Doctors often recommend that people take 800 to 1,200 mg of calcium and 400 IU of vitamin D per day. However, it is not known whether theses amounts would have an effect on migraines. What Else Is This Supplement Used For? See Drug Interactions

References

Last Review: 05-11-2011

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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