Any 'Natural' Products Effective for Migraine?

Douglas S. Paauw, MD

Disclosures

October 30, 2020

The Evidence for Riboflavin

Riboflavin ameliorates oxidative stress, mitochondrial dysfunction, and neuroinflammation. Its ability to reduce migraine frequency was first demonstrated over 20 years ago. A 3-month, placebo-controlled, randomized trial involving 55 adults found that almost two thirds of those treated with 400 mg of riboflavin reported a reduction in headache frequency of at least 50%.The same degree of improvement was reported by 15% of the placebo group (P < .002).

Studies conducted in children have also reported benefit. A randomized trial involving 90 children found that high-dose riboflavin reduced both the frequency and the intensity of migraine.

A review article examining 11 clinical trials in both adults and children concluded that although studies have had somewhat mixed results, the majority have shown a consistent positive effect. One important caveat is that most trials have been of short duration, typically less than 3 months, and have not been placebo-controlled.

However, across the board, riboflavin has been found to be generally safe and well-tolerated. Furthermore, it is cheap.

Migraine Prophylaxis

A 23-year-old woman reports that her migraines are becoming more frequent. She now experiences them, on average, 6-8 days per month.

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