A Little Riboflavin Goes a Long Way for Migraine Relief

by Alan R. Gaby, MD

Supplementing with relatively small amounts of riboflavin (vitamin B2) may reduce the frequency and severity of migraines in chronic sufferers, reports a study in Headache (2004;44:885–90). Previous studies showing that riboflavin can prevent migraines used 400 mg per day, which is at least 200 times the amount in a typical diet. In the new study, 25 mg per day appeared to be effective.

Riboflavin was originally considered for migraine prevention because researchers observed that migraine sufferers tend to have impaired energy production in brain cells, which riboflavin has the potential to enhance as it is a component of a key substance involved in the body’s energy production. Another nutrient important for producing energy (magnesium) has already been shown to reduce migraine recurrence. In earlier studies with riboflavin, a very high dose was chosen, presumably to give the vitamin the best chance of working. While riboflavin does not appear to cause any significant adverse effects even at high doses, it

is possible that taking large amounts of any single nutrient might cause subtle imbalances in body chemistry. For that reason, if lower doses are equally effective, they are preferable to higher amounts.

Fifty-two people suffering from recurrent migraines participated in the three-month study. They were randomly assigned to receive either a daily combination of riboflavin (400 mg), magnesium (300 mg), and the herb feverfew (100 mg), or 25 mg of riboflavin per day. Each of the three components of the combination product has been shown in earlier research to reduce the recurrence rate of migraines. A positive response was defined as a reduction in the frequency of migraines by 50% or more. Forty-two percent of participants responded to combination therapy and 44% responded to low-dose riboflavin. In addition, the average headache severity and the number of days with tension headaches decreased significantly in the low-dose-riboflavin group, but not in the group receiving combination therapy.

Because there was no control group in the new study, one cannot rule out the possibility that

the beneficial effects of low-dose riboflavin were due to a placebo effect. However, the researchers considered that possibility unlikely, because the effects of riboflavin were greater than those found with a placebo in previous migraine studies.

In addition to riboflavin, magnesium, and feverfew, coenzyme Q10 has been found in one preliminary trial to reduce the recurrence rate of migraines. Dietary factors also appear to be important migraine triggers in susceptible people. For some, tyramine-containing foods such as certain wines and aged cheeses are the main offenders. For others, allergic reactions to common foods such as wheat, oranges, egg, coffee, tea, and beef seem to be the main triggers.

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