Different nutraceuticals and supplements have been studied for migraine prevention. These products are often perceived as safer and «more natural». Overall, supplements are active substances and should be managed exactly like medications. 

A few comments can be made on supplements. 

  • There are multiple brands of supplements. It’s important to verify that the correct dose is used. The number of pills, capsules, grams of powder etc required may vary. 
  • For magnesium, different kinds exist and some forms (like oxide) are not proven for migraine prevention. Citrate and glycinate are preferred.
  • As the doses used for prevention are quite high, it’s not very helpful to try to get these nutraceuticals through diet only. 
  • Supplements are often well tolerated, but still may have side effects.
  • Supplements are not necessarily safe during pregnancy, you should discuss with your health care provider 
  • The cost of supplements can be high, and they are not covered by many drug plans
  • If a supplement works to prevent your migraines, it should not be stopped abruptly as it can lead to a deterioration. 

Table: Overview of nutraceuticals used for migraine prevention


Dose

(may be divided in separate doses)

MechanismSide effects
Magnesium
Citrate or glycinate		600 mg/day
Stabilizes neuronal membrane Plays a role in energy metabolismDiarrhea
Gastro-intestinal cramps
Vitamin B2
(riboflavin)		400 mg/day
Plays a role in energy metabolismMakes urine darker yellow 
Coenzyme Q10300 mg / dayPlays a role in energy metabolism
Antioxydant
Petasites Hybridus
Butterbur		150 mg/dayAction on TRPA1 channels, proteins that are receptive to oxidative stressStomach upset and burping  
Concerns of liver toxicity, not used anymore
Tanacetum Parthenium
Feverfew
Action on TRPA1 channels, proteins that are receptive to oxidative stressMay interact with medications like Coumadin

Some brands (Migravent, Migrelief, many others) propose combinations of supplements, sometimes with other products for which there is not much evidence. Any trial should be done the way you would test a medication, with a diary, so you can make a decision based on facts. 

REFERENCES

Rajapakse T, Pringsheim T. Nutraceuticals in Migraine: A Summary of Existing Guidelines for Use. Headache. 2016;56(4):808-16.

Orr SL. Diet and nutraceutical interventions for headache management: A review of the evidence. Cephalalgia. 2016;36(12):1112-33.

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