Dr. Jordan Robertson BHSc. ND RAc
My introduction to Naturopathic Medicine was for treatment for my migraines. I could never identify my triggers, with headaches happening multiple times per month. Sleep was the only thing that worked to get rid of them, and nothing seemed to prevent them from coming. – Dr. Jordan Robertson ND
The research on supplementation for migraines is well established. We seem to be able to decrease a patient’s number of headache days per month with nutrients such as magnesium(1), riboflavin (B2), CoQ10 and melatonin(2) and we can further prevent headaches by focusing on other possible causes such as diet or hormones(3). Melatonin has been best studied in migraines of children, and can safely be used in adults and children alike to prevent migraine headache attacks(4,5).
Both the Canadian Headache Society(6) and the American Academy of Neurology and Headaches (7) both rate the evidence for using magnesium to be as effective as most other drugs used for migraine prophylaxis. A review of all of the literature on both oral and IV magnesium showed that IV magnesium can abort a current headache in 15-45 minutes in many patients, and patients following and IV report better pain scores at 2 hours and 24 hours following an infusion(1). Many trials have looked at oral magnesium as co-management of migraines with other medications, or alone, and have found similar effect (although not quite as rapid) as IV administered magnesium.
Treatments for migraines are prescribed based on the severity and loss of function associated with a patient’s headaches. IVs as little as once per week for 4-6 weeks can reduce headache frequency, provides further benefit to diet support and daily supplementation of mitochondrial supports such as CoQ10. Often patients maintain the benefit they initially acquire from their IVs with simple oral supplementation, and IVs can be discontinued or used as an emergency-only treatment.
Patients who need to continue their migraine medications should be assessed for low vitamin D. Studies have shown that co-administration of vitamin D with migraine drugs can improve the effect of medication, and decrease the number of migraine attacks(8).
If you experience more than 8-10 migraine days per month, or have progressed to requiring prophylactic migraine medication, it’s worth a conversation to find out what your options are. A decrease of your headache days per month by 50% can be considered significant, and all of the above mentioned treatments reliably reduce headache frequency by at least 50% in clinical trials. Combination treatment with diet and supplementation can only improve our success, and improve each of our migraine sufferers’ quality of life.
- Chiu H-Y, Yeh T-H, Huang Y-C, Chen P-Y. Effects of Intravenous and Oral Magnesium on Reducing Migraine: A Meta-analysis of Randomized Controlled Trials. Pain Physician. 2016 Jan;19(1):E97–112.
- Gaul C, Diener H-C, Danesch U, Migravent® Study Group. Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial. J Headache Pain. 2015;16:516.
- Ambrosini A, Di Lorenzo C, Coppola G, Pierelli F. Use of Vitex agnus-castus in migrainous women with premenstrual syndrome: an open-label clinical observation. Acta Neurol Belg. 2013 Mar;113(1):25–9.
- Fallah R, Shoroki FF, Ferdosian F. Safety and efficacy of melatonin in pediatric migraine prophylaxis. Curr Drug Saf. 2015;10(2):132–5.
- Miano S, Parisi P, Pelliccia A, Luchetti A, Paolino MC, Villa MP. Melatonin to prevent migraine or tension-type headache in children. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 2008 Sep;29(4):285–7.
- Pringsheim T, Davenport WJ, Mackie G, Worthington I, Aubé M, Christie SN, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci J Can Sci Neurol. 2012 Mar;39(2 Suppl 2):S1–59.
- Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1346–53.
- Cayir A, Turan MI, Tan H. Effect of vitamin D therapy in addition to amitriptyline on migraine attacks in pediatric patients. Braz J Med Biol Res Rev Bras Pesqui Médicas E Biológicas Soc Bras Biofísica Al. 2014 Apr;47(4):349–54.