How to use non-pharmacologic treatments for migraine

Vitamin and mineral supplements can be found almost anywhere, promising to treat all kinds of ailments from the shelves of your pharmacy to the virtual aisles of Amazon. These alternative treatments, called nutraceuticals—a portmanteau of the words “nutrition” and “pharmaceuticals”—are food-derived products that may potentially have therapeutic benefit.

While studies have shown some nutraceuticals to be effective and safe for people with migraine, others carry additional risk. Dr. Abigail Chua, a neurologist at Hartford HealthCare Medical Group, explains what to look for when using supplements for migraine treatment.

Nutraceuticals and Migraine Treatment

Studies have shown that 80% of people with headache disorders have used some form of alternative medicine, including nutraceuticals, for headache treatment, said Dr. Chua. And there is some value to moving forward with this option. Multiple studies have been conducted evaluating non-pharmacological treatments for their efficacy and safety. The most common are:

  • Magnesium—a mineral used to prevent migraine attacks
  • Riboflavin—a vitamin also known as B2, which in high doses has been shown to prevent migraine attack
  • Co-enzyme Q10 (CoQ10)—an antioxidant that, when taken regularly for migraine prevention, has been shown to reduce frequency and intensity of migraine

Feverfew—a plant that can be used as a preventive treatment for migraine—is another commonly used nutraceutical, but its effectiveness has not been well-proven in studies.

Other alternatives often cited for migraine treatment include butterbur, tree bark, lavender, peppermint, and ginkgo biloba, and there are “tons and tons of others” out there, Dr. Chua said, but there is less evidence available that supports their efficacy.

Are Nutraceuticals Safe?

Many studies have been conducted to explore the potential benefits of nutraceuticals both for migraine prevention and acute headache treatment. It’s important for people with migraine to do their homework before incorporating anew therapy into their treatment plan. “When it comes down to it,” Dr. Chua said, “we want to make sure that we’re using treatments that have some sort of scientific backing.” It’s important to recognize that not all studies are created equal. Some studies may be more vulnerable to bias; others may not include enough participants to prove a significant benefit, or the results just may be too incomplete for doctors to determine whether a treatment is a good option for people with migraine. Your doctor can help you understand if a specific supplement is right for you.

How are Nutraceutical Regulated?

“Nutraceuticals in the United States are considered food, not medicine, so they don’t fall under the same regulations,” says Dr. Chua. “While companies have a responsibility to conduct responsible, safe, and ethical business practices, they don’t really have to conduct research proving that their product is safe or effective at all.”

Dr. Chua points to one example that shows just how unregulated the U.S. supplement industry can be. “In 2005, products from four major vitamin distributors were found to not only contain none of the herbals that they said were on their labels, but also had no medicinal properties and were mostly filled with fillers, like powdered rice.” When doctors like Chua recommend certain nutraceuticals—such as magnesium, riboflavin, and CoQ10—it’s because high-quality studies have demonstrated their efficacy and safety, and because they are available from trustworthy supplement providers.

What are the Risks of Taking Nutraceuticals?

When taking any supplement, especially without first consulting your doctor, there is always a chance that the supplement will simply be ineffective—but in the worst-case scenario, they can actually be harmful. The problem is that many people add nutraceuticals to their treatment plan, thinking they are more like vitamins, rather than medications that could have potentially harmful side effects.

“Natural’ does not necessarily mean safe,” said Dr. Chua.

For people interested in trying nutraceuticals for migraine, Dr. Chua says it’s important to do your research. Before anything, be sure to talk to your health care provider about your goals for treatment and whether supplements should be a part of your therapy plan. Don’t be afraid to mention alternative treatments to maintain an honest dialogue with your health care provider. The most important thing to remember about nutraceuticals in migraine treatment is “to have an open dialogue and honest conversation with your health care provider,” Dr. Chua said.