Migraine Headaches: Natural Remedies

As a sufferer of tension migraines (in all reality, who isn’t these days?), I tend to choose natural remedies for relief versus taking over the counter or prescription medications for treatment. The diagnosis of a “headache” really is just an umbrella to cover what type you are dealing with. There are many subgroups when it comes to the definition of a headache. Could it be related to tension from staring at a computer all day, writing emails, or dealing with a constant load of stress? Could it be related to allergies/sinus issues? Could it be related to a food trigger? Could be related to hormonal changes? Or is your immune system so run down that a headache is your body’s way of telling you to slow down. Regardless of the type of headache, a headache is a headache, and it can completely alter your activities of daily living and leave you unable to enjoy the people and things that bring joy into your life.

In this blog post, I am going to be giving a general overview of “natural remedies” that have been used and studied in treating headaches and/or migraines. Most of us have suffered from a migraine headache at one time or another, and unfortunately some suffer more than others. These remedies are the top researched natural treatments for migraine headache and can be used during an attack or prophylactically to prevent further attacks.

Magnesium Did you know that about 75% of the population has a poor intake of magnesium in their diets and it’s believed to be the most common mineral deficiency in the US (M.T. Murray, J. Pizzorno. 2012. The Encyclopedia of Natural Medicine. Page 806.)?! Many clinical studies have proven that magnesium deficiency is extremely prevalent in headache and migraine sufferers, and replacement of this deficiency significantly improves resolution of the symptoms (1, 2). For our science peeps out there: “Magnesium has been a proposed treatment option for migraines due to its blockade of the glutamatergic N-methyl-D-aspartate (NMDA) receptor, a receptor known to be an active contributor to pain transmission and cortical spreading depression” (3) Factors that are assumed to cause deficiency include, but are not limited to, acute and chronic stress, inadequate nutritional intake, excessive alcohol intake, and medications that block magnesium absorption. The goal with magnesium is to use it as a preventative treatment rather than during acute headache/migraine attacks. And if you really want to know if you have a “true” deficiency you can ask your general practitioner to test for an ionized magnesium level as it shows deficiency in earlier stage than a regular magnesium serum. It is believed in medical literature that a low serum magnesium is actually reflective of the later stages of not having enough magnesium in your system. For our generally healthy patient with no co-morbidities who is not taking any prescription medications, we usually recommend taking magnesium oxide 400mg daily for prophylaxis treatment. The most common side effects of taking magnesium oxide are nausea and diarrhea. If these occur we recommend to collaborate with your general practitioner and discuss a possible dosage adjustment.

Riboflavin (Vitamin B2) “Migraine headaches may be the result of a deficit in the production of energy by the mitochondria, the energy-producing compartment of the cell.” (M.T. Murray, J. Pizzorno. 2012. The Encyclopedia of Natural Medicine. Page 806.) Vitamin B2 (or riboflavin) has been proven to be a pertinent element in mitochondrial activation and has been studied since the 1980s in regards to its benefits in migraine prevention. “According to the American Academy of Neurology, riboflavin is considered a level B therapy in migraine prophylaxis” (4), which means there is moderate evidence for it’s benefit in migraine headache prevention and treatment. Riboflavin is also much cheaper than prescription migraine therapies and is a natural remedy, hence making it even more appealing to patients. In a recent systematic review looking at 5 clinical studies (5), riboflavin was shown to have benefits in decreasing the “frequency, severity, duration, and related disability, and facilitates acute therapies of migraine attacks” (6). 400mg daily of riboflavin was compared with 500mg daily of sodium valproate and 80mg daily of propranolol (both pharmaceutical migraine medications), and the study results showed there was no “statistical differences between groups in their prophylactic actions, with a more favorable side effect profile in the riboflavin groups” (7). Also, 400mg daily of riboflavin showed a 59% reduction in migraine attacks in a double-blind placebo controlled study (meaning one group took the riboflavin and one group did not, and neither group which one they were taking). Lastly, “two open-label trials using 400 mg/day of riboflavin have decreased migraine attack frequency from 4 attacks per month to 2 attacks per month, and from 8.7 attacks per month to 2.9 attacks per month, respectively” (8). Now, that is a lot of data to throw at you, but I just want to emphasize the benefits of riboflavin’s daily use in the prevention of migraine attacks and show that the clinical evidence is pretty strong.

Feverfew This herbal preventative agent gained notoriety in the 1980s when a survey conducted showed that 70% of a 270 patient group reported a decrease in the frequency or intensity of their migraine headaches while taking feverfew daily. The clinical evidence from then until about 2015 really had very weak results and it was determined there wasn’t enough substantial evidence to promote the use of this herb. In 2015, a revised systematic review from 2004 added a new “rigorous and larger” (9) study of 218 subjects. This larger study showed a difference between feverfew and placebo by 0.6 attacks per month. The addition of this study helped increase the evidence on the benefit of feverfew, but it is still felt that more is needed before it can be strongly promoted. In a research study conducted in August 2017, a combination supplement containing “100 mg of feverfew, 100 mg of coenzyme Q10, 112.5 mg of magnesium and 1.4 mg of vitamin B6 (to facilitate magnesium absorption)” was tested. (10) The supplement was taken every morning for 3 months. A significant decrease in the frequency and intensity of migraine headaches was demonstrated along with a benefit in reducing symptoms of anxiety and depression. This study emphasized that more clinical research should be dedicated to this combination due to its positive effects.

Butterbur Dating back almost 900 years, butterbur has been used for the prevention of migraine headaches for some time. An herb, like feverfew, butterbur “has been shown to reduce spasm of blood vessels as well as the formation of inflammatory compounds” (M.T. Murray, J. Pizzorno. 2012. The Encyclopedia of Natural Medicine. Page 806.). Specifically, the extract from butterbur called Petadolex has been clinically studied and was shown to reduce migraine headache frequency and intensity. In a clinical study of 60 patients, a significant reduction in migraine headaches was seen when 50mg Petadolex was given twice a day for 12 weeks (in comparison to a placebo group). By 4 weeks there was a 46% decrease of attacks, and a 60% reduction was seen at 8 weeks. At the 12 week mark an additional 50% reduction was shown. There is still little clinical support of this extract, although many other websites have reported and documented its benefit as an herbal migraine prophylaxis treatment. The main side effect to watch out for is diarrhea, so be aware!

Combo of Vitamin B6, Vitamin B9, and Folic Acid This vitamin combination has some potential to decrease homocysteine levels, thus preventing migraine headache attacks. In one clinical study reviewed, a combination of 2mg folic acid, 25mg of vitamin B6, and 400mcg of vitamin B12 reduced homocysteine levels by 39% when compared to placebo (11). It also showed a 30% reduction in migraine disability (pain, frequency, duration, etc), whereas the placebo arm did not report any reduction. Also, a study conducted on Australian caucasian women using this similar combination demonstrated a reduction in homocysteine levels and the severity of migraine headaches. Now, this may not work for everyone as they believe there is a genetic factor in these vitamins’ ability to decrease homocysteine levels an their resulting benefit in migraine headache reduction.

Vitamin E If you suffer from menstrual migraines, listen up! There are many factors that are considered when menstrual migraines are of concern, including magnesium reduction (the first vitamin supplement I mentioned). Another consideration is the huge influx of prostaglandin (PG) levels during the menstrual cycle which begin during the follicular and luteal phase and continue to increase during menstruation (12). Pharmaceuticals were created to suppress this increase of PG levels. Well did you know “vitamin E inhibits the release of arachidonic acid and the conversion of arachidonic acid to PG by acting on the enzymes phospholipase A2 and cyclooxygenase” (13)? In simple terms, it does the same thing as these pharmaceuticals! In one clinical study, it was concluded that the use of 400IU of vitamin E daily (taken 5 days during menses) reduces pain severity and and limits the disability incurred by migraine headaches. There does need to be more clinical studies with larger groups performed, but again, anecdotal reports on various websites show a reduction and improvement in migraine headaches in menstruating females. Vitamin E does have a side effect of potential bruising and increased bleeding risk, so please be aware of this as it might have to be stopped prior to a surgical procedure or discontinued if increased bruising is noted.

There are other modalities and natural remedies that are out there, but I wanted to present you with the ones that had the most robust clinical evidence behind them. A simple google search will bring up various blog posts and forums where there are anecdotal reports from patients who report a reduction in, and relief from, migraine headaches with the use of such treatments as acupuncture, essential oils, relaxation techniques, and many other alternative therapies. It’s all about bio-individuality, and what works for one might not work for the other. It’s finding out what is best for YOU and what gives you an effective response. As always, please talk to your general practitioner prior to trying any of the supplements listed above to ensure that they are safe for you. Even though vitamins and supplements are not considered “medications” from a pharmaceutical perspective, they still are considered medicine and can interact with other prescriptions medications you may be taking and might be contraindicated in certain health issues.

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Continue to Follow Your Gut,

Jaci