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Conari Press, an imprint of Red Wheel/Weiser, LLC  is the publisher of Sharron's book, Migraine: Identify Your Triggers, Break your Dependence on Medication, Take Back Your Life -  An Integrative Self-Care Plan for Wellness," released June, 2013. Follow Sharron on Twitter @murraysharron, and her page Sharron Murray, MS, RN on Facebook, for tips to help you battle your migraines and achieve wellness.





In general, our nutritional needs should be met through a healthy diet. However, for many of us with migraine, maintaining a healthy diet that meets our nutritional needs is a challenge. Food and beverage triggers, food cravings, nausea and vomiting, and comorbid diseases with diet restrictions of their own can limit our selection of items and absorption of nutrients.

You might want to ask your doctor for a referral to a nutritionist to help plan your diet and recommend appropriate supplements to avoid nutritional deficiencies if you

  • Find the task of selecting items suitable for your needs overwhelming
  • Have a number of comorbid diseases, and/or
  • Have poor renal or liver function.

That said, many of us seek help for migraine and headache relief through supplements, along with herbs and other complementary therapies, for additional reasons, including 

  • Dissatisfaction with our conventional medical treatment,
  • Unpleasant side effects from medications, and
  • The expense of medications.  

The most common supplements (nutraceutical options) we use to prevent and treat our migraine attacks are

  • Magnesium,*
  • Riboflavin (Vitamin B2),*
  • Coenzyme Q10 (CoQ10),* and
  • Fish oil.  

Keep in mind, while evidence for the effectiveness (efficacy) of some of these supplements is increasing, more research is necessary to establish evidence-based guidelines for others. That said, let's take a closer look at each of them.


Magnesium is a mineral in our bodies that is important for a number of functions, including

  • Protein synthesis,
  • Neuromuscular function,
  • Regulation of nerve cells (calms our nervous system)
  • Regulation of blood sugar
  • Maintenance of vessel tone (keeps our blood vessels from going into spasm), and
  • Regulation of the neurotransmitter, serotonin.

A number of studies have shown that people with migraine have low levels of brain magnesium during attacks. As well, many sources report that we may have lower levels of serum magnesium than others. Additional reasons that may be associated with magnesium deficiency are

  • A diet lacking in magnesium (foods high in magnesium include whole, unprocessed foods such as green, leafy vegetables, nuts, wheat germ, bananas, soy products, milk, and unrefined grains),
  • Alcohol intake as may deplete magnesium from the body,
  • Caffeine intake as may deplete magnesium from the body,
  • Menstruation as levels drop right before onset, and
  • Comorbidities that may also exhibit magnesium deficiency such as mitral valve prolapse, anxiety disorders, and epilepsy.

Symptoms of magnesium deficiency include irritability, agitation, anxiety,confusion, insomnia, restless leg syndrome, muscle spasms, twitching, seizures, weakness, poor coordination, nausea and vomiting, irregular heart rate and rapid heart rate.

Although the most common side effect of magnesium replacement is diarrhea, you should be aware that too much magnesium can lead to toxicity. Symptoms may include hypotension, flushing, slow heart rate, lethargy, drowsiness, respiratory paralysis and death.

As well, you need to know that many medications can interfere with blood levels of magnesium such as diuretics, some antibiotics, calcium channel blockers and other blood pressure medications, chemotherapy drugs, steroids, hormone replacement therapy, and digoxin. In addition, if you have poor renal function you must be careful with magnesium intake as you are unable to excrete excessive amounts via your kidneys. 

Riboflavin (Vitamin B2)

Riboflavin is a water-soluble vitamin that is important for a number of functions in our body, including

  • The breakdown of proteins, fats, and carbohydrates, and
  • Maintenance of the body's energy supply.

It is thought that mitochondrial dysfunction (mitochondria generate the energy for other cells to do their jobs, including those in the brain) and impairment of energy production, may play a role in migraine pathophysiology (Sun-Edelstein and Mauskop, 2011). Some studies have shown that riboflavin, through enhancing mitochondrial function, may help decrease the frequency and severity of migraine attacks. 

Foods high in riboflavin include milk, cheese, eggs, nuts, enriched breads and cereals, whole grains, mushrooms, sweet potatoes, and leafy green vegetables.

Side effects of riboflavin replacement are thought to be minimal. Apart from bright yellow urine, diarrhea may occur.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 is a vitamin-like substance found throughout the body that is thought to

  • Provide energy to cells, and
  • Have antioxidant effects.

Because of its role in mitochondrial function and energy generation, it is believed to work against migraine in much the same way as riboflavin.

Mild side effects of CoQ10 replacement may include loss of appetite, nausea, vomiting, diarrhea, and rash.

Because some sources report that CoQ10 may decrease blood pressure, you should discuss the use of this supplement with your doctor if you are taking

  • High blood pressure (antihypertensives) medications like captopril, diltiazem, and many others.
  • Preventive medications for migraine like beta blockers and calcium channel blockers that may affect your blood pressure.

Because some sources indicate CoQ10 may  increase the risk of bleeding when taken with drugs that increase bleeding, you should discuss this supplement with your doctor if you are taking drugs like advil, ibuprofen, and naproxen. As well, you should discuss this supplement with your doctor if you are taking Coumadin, which is used to slow blood clotting, since CoQ10 may interfere with the effectiveness.

Fish Oil (Omega-3)

Fish oils come from fatty fish. Fatty fish are believed to contain omega-3 (Eicosapentaenoic acid). EPA is thought to

  • Reduce inflammation and swelling,
  • Relax blood vessels, and
  • Inhibit platelet clumping (blood clotting).

Fish richest in EPA are those that inhabit deep, cold water such as tuna, salmon, trout, sardines, herring, and mackeral.

Some studies have suggested that omega-3 may help to decrease the frequency and severity of migraine attacks by affecting prostaglandin levels and serotonin activity.

Because EPA is thought to inhibit platelet clumping, it should not be taken with other blood thinning herbs and medications without your doctors approval. As well, it should be discontinued one-two weeks prior to surgery, or other invasive procedures that may cause bleeding. Please check with your doctor for specific directions.

*You should know that the evidence-based guidelines for NDAIDS and other complementary treatments for episodic migraine prevention in adults have been retired by the AAN Board of Directors on September 16, 2015, due to serious concerns with a preventive treatment butterbur, recommended by this guideline. Retired guidelines are no longer considered valid and are not supported by the AAN. Retired guidelines remain on their website for reference use only.


Murray, S., M.S., R.N. Migraine:Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life. San Francisco: Conari Presss, 2013.

NIH  National Institute of Health. (2011, October 21). Co-enzyme Q-10: MedlinePlus Supplements. Retrieved March 18, 2014 from

Sun-Edelstein, C., M.D., & Mauskop, A., M.D. (2009). "Foods and Supplements in the Management of Migraine Headaches". Clin J Pain. Volume 25, Number 5. pp 446-452. Retrieved from

Sun-Edelstein, C., M.D., & Mauskop, A. M.D. (2011). "Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments". Headache. March, 2011. pp 469-483.

Sharron Murray MS, RN is an author and coauthor CaMEO Study, "Life With Migraine". Currently, Sharron is active in the migraine community as a writer, advocate, American Migraine Foundation Partner, moderator for the American Migraine Foundation "Move Against Migraine" Facebook Group, and member of the National Headache Foundation Patient Leadership Council. 

Follow Sharron on twittter @murraysharron, her Facebook page: Sharron Murray, MS, RN and her website

This article is not intended as a substitute for medical advice. If you have specific concerns about your health or nutrition, please consult a qulaified health professional.

Updated November, 2018

Copyright 2014, Sharron E. Murray 

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