Migraine and Headache Treatment with Nutritional Supplementation

Migraine and Headache Treatment with Nutritional Supplementation

There is a lot of conflicting data out there on what nutrients or supplements can be effective for headache and migraine treatment. The good news is that there is very little risk to the nutrients that have been studied. The nutrients in this article are a good recommendation for most people who suffer from migraines and headaches. Of course, this is not medical advice, and it is always best to consult your healthcare provider.

Magnesium Citrate

A systematic review of the literature published in the journal Headache in 2018 reviewed studies from 1990 to 2016 on supplementation of magnesium citrate. The conclusion of the study was that magnesium as a prophylactic treatment was “possibly effective”, and that it is a “safe and cost efficient strategy in clinical use” (1).  Dr. Smitherman has found that patients have a variable response to magnesium citrate, but that it is a good recommendation for patients suffering from headaches and migraines.

Riboflavin (Vitamin B2)

In a 2017 systematic review of the literature researchers reviewed studies performed between 1966 and 2016. The researchers concluded that “riboflavin is well tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient’s migraine headache frequency.” (2) Dr. Smitherman recommends taking riboflavin as part of a B-complex. B vitamins are typically best taken in combination as they work together in health promotion.

Vitamin D

In a 2019 comprehensive review published in the journal Neurological Science by authors in Iran they concluded that “It seems a high proportion of migraine patients might suffer from vitamin D deficiency/insufficiency. Further, the current evidence shows that in addition to routine drug therapy, vitamin D administration might reduce the frequency of attacks in migraineurs.” (3) Dr. Smitherman has found that many migraine sufferers are deficiency or at the least insufficient in vitamin D. Dr. Smitherman always recommends taking vitamin D3 in combination with vitamin K2 for overall health.

Coenzyme Q10 (CoQ10)

A 2002 study published in the journal Cephalgia done at Thomas Jefferson University in Pennsylvania treated patients with 150 mg per day of CoQ10. The researchers concluded that “coenzyme Q10 appears to be a good migraine preventive”. (4) Dr. Smitherman has seen good results with patients using coenzyme Q10 as a migraine headache preventive.

Fish Oil

A 2002 paper published in the Journal of Adolescent Health investigated the impact of 2 months of fish oil vs olive oil on recurrent migraines in adolescents. The study found that both oils studies resulted in a reduction in migraines. (5) This was an interesting study because it seems that both the fish oil and the olive oil had a positive impact on the migraines. At the onset of the study olive oil was intended to be a placebo. Generally fish oil is a highly recommended supplement for overall health. While the data for fish oil as a migraine headache treatment is not as strong, Dr. Smitherman does recommend it as part of an overall plan.


Butterbur is the common name for the plant Petasites hybridus root. Butterbur is one of the two most popular and studied botanical medicines for migraine headache. A 2002 study published in the journal Neurology by authors from Albert Einstein College of Medicine neurology department concluded that “Petasites extract 75 mg bid is more effective than placebo and is well tolerated as a preventive therapy for migraine. Petasites 50 mg PO bid was not significantly more effective than placebo on the primary study endpoints.” This conclusion is very important, and what it means is that they found 75mg twice per day to be effective compared to placebo and 50mg twice per day to not be effective compared to placebo. This is a very important point, because often when people are not getting results from their treatments it can be because they are not properly dosing the treatment. Dr. Smitherman has seen very good results with butterbur for patients with migraine headaches.


In 2011 a systematic review of Feverfew (Tanecetum parthenium L.) was published in the journal Pharmacognosy Review. In the review the authors recommended “For migraine headaches: Take 100–300 mg, up to 4 times daily, standardized to contain 0.2–0.4% parthenolides. Feverfew may be used to prevent or to stop a migraine headache. Feverfew supplements may also be CO2 extracted. For these, take 6.25 mg, 3 times daily, for up to 16 weeks.” Feverfew can be a powerful addition to a migraine headache treatment plan.

If you think you could benefit from working with Dr. Smitherman please book a free 15 minute consultation or appointment online.

Literature Citations

  1. Von Luckner, V., Riederer, F. Magnesium in migraine prophylaxis – is there an evidencce-based rationale? A systematic review. Headache. 2018 Feb;58(2):199-209. doi: 10.1111/head.13217. Epub 2017 Nov 13.
  2. Thompson, DF., Saluja, HS. Prophylaxis of migraine headaches with riboflavin: a systematic review. J Clin Pharm Ther. 2017 Aug;42(4):394-403. doi: 10.1111/jcpt.12548. Epub 2017 May 8.
  3. Ghorbani, Z., Togha, M., Raflee, P., Rasekh Magham, R., Haghighi, S., Razeghi Jahromi, S., Mahmoudi, M. Vitamin D in migraine headache: a comprehensive review on literature. Neurol Sci. 2019 Dec;40(12):2459-2477. doi: 10.1007/s10072-019-04021-z. Epub 2019 Aug 3.
  4. Rozen, TD., Oshinsky, ML., Gebeline, CA., Bradley, KC., Young, WB., Shechter, AL., Silberstein, SD. Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia. 2002 Mar;22(2):137-41.
  5. Harel Z., Gascon, G., Riggs, S., Vaz, R., Brown, W., Exil, G. Supplementation with omega-3 polyunsaturated fatty acids in the management of recurrent migraines in adolescents. J Adolesc Health. 2002 Aug;31(2):154-61.
  6. Lipton, RB., Gobel, H., Einhaupl, KM., Wilks, K., Mauskop, A. Petasites hybridus root (butterbur)  is an effective preventive treatment for migraine. Neurology. 2004 Dec 28;63(12):2240-4.
  7. Pareek, A., Suthar, M., Rathore, G., Bansal, V. Feverfew (Tanecetum parthenium L.): A systematic review. Pharmacogn Rev. 2011 Jan-Jun; 5(9): 103-110. Doi: 10.4103/0973-7847.79105