It is estimated that up to 25% of the US population suffers from migraine. Migraine is a neurological condition characterized by intense and disabling headache. Migraine headaches are vascular rather than tension headaches. Migraines are often accompanied by hypersensitivity to light, hypersensitivity to sound, and nausea. The unpredictability and disabling nature of the headaches can make it difficult or even impossible for sufferers to hold a job. It is estimated that migraines are responsible for the loss of about $13 million per year in missed workdays and lost productivity. Triggers precipitating headaches vary tremendously. Response to treatments varies widely from patient to patient and even for the same person from occurrence to occurrence.

Studies indicate that migraine is one symptom of disorders of the serotonergic control system. Serotonin acts both as a hormone and neurotransmitter with many different receptors. Viewing migraine as a symptom of many different disorders may help to explain the inconsistencies in symptoms and response to treatments. About 75% of migraine sufferers are female although migraine affects pre-pubescent boys and girls equally. This would indicate a strong hormonal component to the conditions.

If migraines recur regularly, are problematic, or do not respond to treatment well, it is reasonable to consider preventative therapy. Several dietary supplements have been used to prevent migraines. The most studied are vitamin B2 (riboflavin), magnesium, and Coenzyme Q10 (CoQ10). Riboflavin and CoQ10 both improve mitochondrial energy metabolism. Mitochondrial dysfunction resulting in impaired oxygen metabolism has been proposed as a factor in migraine headaches. Studies have also associated low magnesium levels with migraine headache.

In a recent review of preventative measures for migraine, the American Family Physician recommended that vitamin B2 and CoQ10 be considered as second-line prevention for migraines. First-line prevention measures were established prescription medications such as propranolol and amitriptyline. High-dose riboflavin (400 mg daily) and CoQ10 (100 mg 3 times daily) were possibly effective in preventing migraine with minimal short-term toxicity. The maximum benefit usually took 2 to 4 months to achieve. Studies were not conducted long-term, so long-term toxicities are not known. Vitamin B2 ($5 to $10 per month) and Coenzyme Q10 (about $60 per month) could be low-cost alternatives for the prevention of migraines with very little side effect or risk of toxicity.

References: http://en.wikipedia.org/wiki/Migraine and Sullivan, B., PharmD, Novel Therapeutic Uses of Vitamins, Minerals, and Nutraceuticals, America’s Pharmacist, Nov. 2006.

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