Today we are going to talk about new supplement protocols for people with headaches. So many people have gone back and done these fantastic systematic reviews and meta-analyses of all of the data over the past 30 years with regards to supplements and headaches.
Dr. Barrett offers a comprehensive review of supplement recommendations to assist in holistic care getting to the cause of migraines. Our newsletter last week focused on upper cervical spine misalignments as a cause of migraines and headaches, but nutritional deficiencies may be a part of the full picture. As Dr. Barrett suggests the best way to determine dosage and need of a supplement is with labs. Our Science Based Nutrition panel can determine specific deficiencies and recommended supplement dosage to restore normal function and health.
Let’s start to make a supplement stack.
Magnesium- If there was one thing to prescribe patients with migraines and headaches it would be this. There’s no doubt about it. There was a 2018 systematic review of 204 studies that showed a reduction in migraine frequency with magnesium. Magnesium works by blocking glutamate which is the main excitatory neurotransmitter in your brain. Patients experiencing tension headaches have also seen great results after taking magnesium. For preventative treatment it is suggested to take 400-500 mg per day in glycinate form, usually at night. When used for acute treatment take 1000 mg in liquid or powder form with fluid, salt, and sugar.
Fish Oil- I also recommend fish oil tablets to acute treatment protocol. There was a very interesting 2018 systematic review of 13 different trials that showed a reduction in duration of headaches with fish oil, but not the frequency. Is that because its basically an anti-inflammatory medication, an alternative to Advil, except it’s not going to cause rebound.
Fish- An incredible study where they had people eat 4 to 8 ounces of fish(salmon) everyday. And at the same time take out seed oils, their high inflammatory omega six seed oils, canola, vegetable etc., replaced that with a combination of olive oil and macadamia nut oil to increase the smoke point of the olive oil. What they saw is that headaches dropped in half in 3 months. This is one of the most powerful diet intervention studies that has ever been done for headaches. With the actual numbers being that people drop from having 16 headaches days per month to 9. That is a powerful effect that is better than most prescription medications.
Mitochondrial Helpers
Riboflavin(B2)- There was a randomized controlled trial in 1998 that set the dose for all subsequent studies. Although nobody has ever done a dose ranging study. So we don’t really know how much to take a day. There was a 2022 meta-analysis of nine studies that showed reductions in migraine frequency and severity. So it’s good as a preventative and an acute.
COQ10- Once again we do not know the best dosage for this. A 2021 meta-analysis of 6 studies showed reductions in migraine duration and frequency. COQ10 also functions as both a preventative and an acute. The dose used in this study was 100 mg 3 times a day, but there is no reason to think you can’t put that into a single dose.
Melatonin- There was a study published in 2016 of a randomized clinical trial comparing melatonin 3 mg to amitriptyline 25 mg, and then both of those to placebo for migraine intervention. What they found is that melatonin worked as well as amitriptyline with way fewer side effects, no constipation, no weight gain, 0 effect on mood, except possibly in a positive direction via sleeping better. There was a significant benefit for melatonin compared to placebo. Is this strictly due to the effect on sleep? Getting better sleep means fewer headaches. Is it the melatonin directly affecting headache reduction? We still do not know, but we do know the patients benefited from taking it.
Vitamin D- We all know how important vitamin D is for the brain. Vitamin deficiency is a known cause of dementia. So it’s essential for proper functioning of the brain and brains that aren’t healthy have more headaches and migraines. We aren’t exactly sure how it helps migraines but we know it helps the brain. Most studies have used 2000 IU per day. But are we sure about that dose? Shouldn’t we just be looking at levels and supplement vitamin D up to a level of 50 to 70? I have no recommendation on the dosage of vitamin D. I think it should be targeted based on what your patient needs. There was a 2021 meta-analysis of 5 studies that showed reductions in migraine frequency. It is definitely making the brain healthier making it less likely to generate headaches and migraines.
A solution to taking these supplements is to wrap them into 1. What this multivitamin needs to contain is COQ10, Riboflavin(B2) and Vitamin D. Split up into a morning and night stack. With the multivitamin being taken in the morning with the fish and fish oil. Then the magnesium and melatonin at night. Even after the headaches and migraines subside you should still take the same stack! By taking this stack you could be fixing a problem you dont know about genetically.
What about Feverfew and Butterbur?
Feverfew- A review of 6 studies in 2020 showed a decrease of less than 1 attack per month. Is that significant enough to add onto the supplements that are already so powerful. It also causes vasoconstriction so it can’t be taken when pregnant.
Butterbur- The original CGRP; it directly blocks the last step in the pain cascade that produces headaches. It works but it is difficult to get a PA free formulation. PA causes liver failure that can result in transplants. Some are labelled PA free and are not. The risk is not worth it.
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