Migraine headaches are more than just really bad tension-type headaches. Migraine is a disabling neurological disease that keeps its victims from living and working normally.
Migraine is the third most prevalent disease in the world and the sixth most disabling disease in the world. Nearly one in four American households has a family member who suffers from migraine headaches [Migraine Research Foundation].
- Migraine affects three times as many women as men.
- Migraine is most common between the ages of 25 and 55 years.
- Migraine is a very expensive disease, both in terms of the expenditures for treatment and in terms of the lost production [Migraine Research Foundation]
Prophylactic treatment of migraine
Despite the prevalence and economic expense of migraine headaches, there are few medications approved to prevent its occurrence, and even fewer medications that do not have potentially serious adverse effects [Shoeibi].
Among the nutritional supplements that may be effective in reducing the frequency and severity of migraine headaches, three seem to have shown some preliminary benefits, sometimes in combination [Shoeibi; Guilbot]:
- Coenzyme Q10
- Riboflavin (vitamin B2)
In the article that follows, I want to summarize the most recent clinical studies showing positive outcomes of nutritional supplementation.
Coenzyme Q10 as an adjunctive treatment for migraine
Dr. Shoeibi et al assigned 36 adult migraine patients to a Coenzyme Q10 treatment group and 37 adult migraine patients to a control group. The patients received 100 milligrams of Coenzyme Q10 or matching placebo daily in addition to their current preventive medications. In the Coenzyme Q10 group, there was a significant reduction in the number of migraine attacks per month and a significant reduction in the severity of the migraine attacks.
There were no adverse effects of adding the Coenzyme Q10 treatment to the regular treatment. Coenzyme Q10 as an adjuvant treatment reduced the frequency, the duration, and the intensity of the migraine attacks [Shoeibi 2017].
Dr. Dahri et al investigated the effect of daily Coenzyme Q10 supplements on bio-markers of inflammation in non-menopausal migraine patients aged 18 to 50 years. Following a one-month run-in period, the patients received 400 milligrams of Coenzyme Q10 or matching placebo per day in addition to their normally prescribed preventive medication for three months [Dahri 2018].
The Coenzyme Q10 supplements acted as an anti-inflammatory agent, significantly reducing the serum levels of the inflammation bio-markers calcitonin gene-related peptide (CGRP) and tumor necrosis factor-α (TNF-α).
The Coenzyme Q10 supplementation was also associated with a significant improvement in the frequency, the severity, and the duration of the migraine attacks [Dahri 2018].
Dr. Sandor et al compared Coenzyme Q10 (3 x 100 milligrams/day) with matching placebo in 42 adult migraine patients in a double-blind, randomized, placebo-controlled trial. The Coenzyme Q10 was well tolerated and was associated with better results than placebo [Sandor 2005]:
- reduced frequency of migraine headaches
- reduced number of migraine days
- reduced number of days with nausea
Dr. Rozen et al tested the efficacy of Coenzyme Q10 as a preventive treatment for migraine headaches. The researchers treated 32 adult migraine patients with 150 milligrams of Coenzyme Q10 daily for three months.
With the Coenzyme Q10 supplementation, six out of ten migraine patients had more than a 50% reduction in the number of days with migraine headaches. There were no side-effects associated with Coenzyme Q10 [Rozen 2002].
Coenzyme Q10 and magnesium in combination for migraine
Dr. Guilbot and colleagues investigated the effects of daily supplementation with 100 milligrams of Coenzyme Q10, 112.5 milligrams of magnesium, and 100 milligrams of the natural remedy feverfew for 3 months. The supplementation was associated with the following health benefits [Guilbot 2017]:
- significantly reduced number of days with migraine headaches during the third month with the decrease in the number of days progressive from the first month on
- reduced proportion of migraine patients with symptoms of anxiety and depression
- improved quality of life
- no adverse effects
Coenzyme Q10, magnesium, and riboflavin in combination
Dr. Gaul and a team of researchers randomly assigned 130 adult migraine patients (3 or more migraine attacks per month) to an active treatment group or to a placebo group. After a four-week run-in period in which the patients received no prophylactic treatment, the patients in the active treatment group took a daily nutritional supplement for three months that contained vitamins and minerals including the following ingredients:
- Coenzyme Q10: 75 milligrams
- Magnesium: 300 milligrams
- Riboflavin: 200 milligrams
The three months of active treatment resulted in a reduction in the number of migraine days from 6.2 to 4.4 days, which showed a trend towards statistical significance and may well have clinical significance.
Furthermore, the symptoms and the intensity of the migraine headaches were significantly reduced in the active treatment group [Gaul 2015].
Dr. Bianchi and colleagues reviewed published open clinical trials and concluded that the combination of Coenzyme Q10, magnesium, riboflavin, and vitamin B12 has therapeutic potential for the prevention or attenuation of migraine headaches [Bianchi 2004].
Coenzyme Q10 for migraine prevention in children and adolescents
Dr. Hershey et al assessed the Coenzyme Q10 status in 1550 younger migraine patients. The average age of the patients was 13.3 years plus or minus 3.5 years. The patients ranged in age from 3 to 22 years.
Close to 40% of the younger migraine patients’ Coenzyme Q10 status was below the reference range, and the reference range itself is, itself, so wide – 0.36 to 1.59 micrograms per milliliter – that considerably more than 40% of the migraine patients might be thought to have less than optimal Coenzyme Q10 status. Dr. Hershey concluded that Coenzyme Q10 deficiency may be common in cases of pediatric and adolescent migraine [Hershey 2007].
Dr. Hershey and the research team recommended that younger migraine patients with low Coenzyme Q10 concentration be treated with one to three milligrams of Coenzyme Q10 per kilogram of body weight per day.
Follow-up of the younger migraine patients on the Coenzyme Q10 supplementation showed the following results:
- improved Coenzyme Q10 status
- reduced frequency of headaches
- reduced incidence of headache disability
Summary of the Coenzyme Q10 and migraine clinical studies
Administering Coenzyme Q10 to migraine patients – as a single agent, as an adjunctive treatment, and/or in combination with other nutritional supplements such as magnesium and riboflavin – has shown positive results.
It seems likely that mitochondrial dysfunction plays a role in the pathophysiology of migraine. Published clinical study results show that daily supplementation with Coenzyme Q10 can produce significant improvement in migraine patients [Littarru 2007].
Bianchi, A., Salomone, S., Caraci, F., Pizza, V., Bernardini, R., & D’Amato, C. C. (2004). Role of magnesium, Coenzyme Q10, riboflavin, and vitamin B12 in migraine prophylaxis. Vitamins and Hormones, 69297-312.
Cordero, M. D., Cano-García, F. J., Alcocer-Gómez, E., De Miguel, M., & Sánchez-Alcázar, J. A. (2012). Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q10 effect on clinical improvement. Plos One, 7(4), e35677. doi:10.1371/journal.pone.0035677
Dahri, M., Tarighat-Esfanjani, A., Asghari-Jafarabadi, M., & Hashemilar, M. (2018). Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers. Nutritional Neuroscience, 1-9. doi:10.1080/1028415X.2017.1421039
Gaul, C., Diener, H., & Danesch, U. (2015). Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial. The Journal of Headache and Pain, 16516. doi:10.1186/s10194-015-0516-6
Guilbot, A., Bangratz, M., Ait Abdellah, S., & Lucas, C. (2017). A combination of coenzyme Q10, feverfew and magnesium for migraine prophylaxis: a prospective observational study. BMC Complementary and Alternative Medicine, 17(1), 433. doi:10.1186/s12906-017-1933-7
Hershey, A. D., Powers, S. W., Vockell, A. B., Lecates, S. L., Ellinor, P. L., Segers, A., & … Kabbouche, M. A. (2007). Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache, 47(1), 73-80.
Littarru, G. P., & Tiano, L. (2005). Clinical aspects of Coenzyme Q10: an update. Current Opinion in Clinical Nutrition And Metabolic Care, 8(6), 641-646.
Markley, H. G. (2012). Coenzyme Q10 and riboflavin: the mitochondrial connection. Headache, 52 Suppl 281-87. doi:10.1111/j.1526-4610.2012.02233.x
Migraine Research Foundation. (2018). Raising money for migraine research. Retrieved from http://migraineresearchfoundation.org/about-migraine/migraine-facts/
Rozen, T. D., Oshinsky, M. L., Gebeline, C. A., Bradley, K. C., Young, W. B., Shechter, A. L., & Silberstein, S. D. (2002). Open label trial of Coenzyme Q10 as a migraine preventive. Cephalalgia: An International Journal of Headache, 22(2), 137-141.
Sándor, P. S., Di Clemente, L., Coppola, G., Saenger, U., Fumal, A., Magis, D., & … Schoenen, J. (2005). Efficacy of Coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology, 64(4), 713-715.
Shoeibi, A., Olfati, N., Soltani Sabi, M., Salehi, M., Mali, S., & Akbari Oryani, M. (2017). Effectiveness of Coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial. Acta Neurologica Belgica, 117(1), 103-109. doi:10.1007/s13760-016-0697-z
The information presented in this review article is not intended as medical advice and should not be used as such.
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