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Neutraceuticals

Natural Relief

Just because a medicine or supplement doesn't require a prescription, it can still be effective in preventing migraine attacks or reducing their frequency. There are a few supplements that have been used widely by people with migraines and have proven to be safe and effective. Here, we will review them.​

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Supplements for Migraine:

Magnesium

  • Recommended dose: 400-600mg daily

  • How it helps: Helps regulate nerve and muscle function, reduces brain hyperexcitability

  • Best forms is magnesium glycinate. The other formulations are harder on the stomach.

  • While magnesium glycinate is best tolerated, it's often more expensive ($20-40/month)

  • If cost is a concern, magnesium oxide is less expensive ($5-15/month) but may cause more GI issues

  • Tips: Start with a lower dose and increase gradually to avoid digestive issues

  • Common side effects: Loose stools, stomach upset

Vitamin B2 (Riboflavin)

  • Recommended dose: 400mg daily

  • How it helps: Improves cellular energy production and may reduce migraine frequency

  • Tips: Take with food in the morning (may cause bright yellow urine)

  • Common side effects: Minimal; generally well-tolerated

Coenzyme Q10 (CoQ10)

  • Recommended dose: 100-300mg daily

  • How it helps: Supports mitochondrial function and energy production in cells

  • Tips: Best absorbed when taken with a meal containing some fat

  • Common side effects: Mild gastrointestinal upset in some people

Feverfew

  • Recommended dose: 50-100mg daily

  • How it helps: May reduce inflammation and prevent blood vessel changes that trigger migraines

  • Tips: Look for standardized extracts

  • Common side effects: Mouth sores in some people, mild digestive issues

Butterbur

  • SAFETY WARNING: Due to concerns about liver toxicity, butterbur is no longer widely recommended for migraine prevention

    • ​Several countries have restricted or banned its use

    • Recommendation: Discuss with your healthcare provider. Safer alternatives are available.

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Timing Tips

  • Magnesium: Can be split into 2 doses- morning and night

  • B2: Morning dose preferred due to energy effects

  • CoQ10: With your largest meal of the day

  • Feverfew: Can be taken any time but be consistent

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Important Considerations

  1. Always consult your healthcare provider before starting supplements:

    • Some supplements can interact with medications

    • Certain medical conditions may make some supplements unsafe

    • Pregnancy and breastfeeding may affect supplement safety

      • If you are pregnant or breastfeeding, contact a provider prior to starting any medication or supplement.

  2. Quality matters!

    • Choose supplements from reputable manufacturers

    • Look for products tested by third-party organizations

    • Check for USP or NSF certification when possible

  3. Give it time:

    • Most supplements need 2-3 months of consistent use to show benefit

    • Keep a headache diary to track effectiveness

    • Don't start multiple supplements at once

  4. Storage and usage:

    • Follow storage instructions on the label

    • Check expiration dates regularly

    • Take as directed with or without food as specified

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Cost Considerations

  • Most supplements are not covered by insurance

  • Prices can vary significantly between brands and retailers

  • Some combination products may be more cost-effective than buying supplements separately

  • FSA/HSA accounts often cover supplements with a Letter of Medical Necessity

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Combination Products

Several excellent products on the market combine some of the aforementioned supplements and are available for purchase online. TheHeadacheNP does not endorse any of these products nor do we receive compensation for purchases. This information is being provided solely for informational purposes. 

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When to Stop/Call Your Provider

  • If you experience unusual side effects

  • If migraines worsen

  • If you develop new or different types of headaches

  • If you notice signs of allergic reaction

  • Before any surgical procedures (stop 2 weeks prior)

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Click here for more information on this topic from the American Headache Society.

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References

Cerritelli, F., Patel, M. N., Birch, J., & Chaibi, A. (2023). Nutraceuticals for migraine: A comprehensive review of clinical evidence. European Journal of Neurology, 30(2), 380-391.

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González-Hernández, A., Marichal-Cancino, B. A., & MaassenVanDenBrink, A. (2023). Nutraceuticals in migraine: A systematic review. The Journal of Headache and Pain, 24(1), 12.

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Hajjarzadeh, S., Mahdavi, R., Shalilahmadi, D., & Nikniaz, Z. (2021). The effects of coenzyme Q10 supplementation on primary headaches: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 58, 102682.

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Nattagh-Eshtivani, E., Dahri, M., Hashemilar, M., & Tarighat-Esfanjani, A. (2023). The effect of vitamin B2 supplementation on migraine prophylaxis: A systematic review and meta-analysis of randomized controlled trials. Nutritional Neuroscience, 26(1), 23-34.

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Rajapakse, T., & Pringsheim, T. (2023). Nutraceuticals in migraine management: A systematic review. Canadian Journal of Neurological Sciences, 50(1), 35-47.

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