FAQ Episode 40: Vitamin Deficiencies predict migraine risk

Frequently Asked Questions about Natural Migraine Relief

A recent study confirmed what we have suspected for some time: patients with migraine who have multiple vitamin deficiencies may experience worse headache outcomes compared to patients who only have one vitamin deficiency.

We know from numerous studies that deficiency of a single vitamin, like riboflavin, CoQ10, Vitamin D, niacin or magnesium can be associated with migraine. Recent research presented at the June 2024 American Headache Society’s 66th Annual Scientific Meeting demonstrated how having multiple vitamin deficits can impact patients with migraine.¹

Finally, a study looks at multiple vitamin deficits

Vitamin supplementation has now become (or should be!) a common treatment for patients with migraine or severe headache. While studies have examined associations between individual vitamins and migraine, there has been a paucity of research on how multiple vitamin deficits may impact patients with migraine.

Im this study, investigators from Cincinnati Children’s Hospital Medical Center conducted a retrospective chart review of migraine patients seen at the center between January 1998 and June 2023. All patients had serum levels of Vitamin D, riboflavin, folate, and CoEnzyme Q10 drawn at their initial visit. The 3,430 patients included in the study were divided into five groups:

• 184 had no vitamin deficiencies;

• 830 had one deficiency,

• 1234 had two deficiencies;

• 898 had three deficiencies and

• 284 had four deficiencies.

Seventy percent of these migraine patients had two or more deficiencies! This is a common reason why those taking only a single supplement to help with migraines are often disappointed in the response! Clapping with one hand = limited results. Gee, big surprise?

Investigators found that there were statistically significant differences in number of vitamin deficiencies between all groups, with older aged patients having the greatest deficits. They found significant differences between the mean migraine disability scores of the group with one deficiency as compared to the groups with three and four deficiencies.

The practical application of this study

While in principle I agree with the authors of this study who recommended that ”obtaining serum vitamin levels to assess for deficiency appears to be a reasonable step in the management of patients with chronic migraine…,” I would add four related thoughts:

1. While that’s a great idea in a research setting, it may not be practical or cost effective to check all levels in practical clinical settings. I definitely agree with getting a Vitamin D3 level for everyone with migraine, but other vitamin levels can be costly and may not be be covered by regular insurance.

2. If you end up with a low normal result, you may conclude that “If I’m in the normal range, I must be fine, then.” We know that a result on the low end of normal may be “normal” for 20% of people, and relatively deficient for the other 80%. We don’t usually know enough about your genetic blueprint to know your optimal “normal.” level particularly when there is a chronic stress factor like severe headaches. A homocysteine test as a marker for a genetically programmed methylated B vitamin deficiency could be an exception to this rule.

3. These nutrients have some degree of interactive synergy in their benefit for migraine, and if you have sub-optimal levels, taking them in concert can be more effective than taking any one of them alone.

   1. While the vitamins they studied are the most common deficits, sub-optimal levels of other nutrients like the methylated Bs (B12, B6 and folate), thiamine, Vitamin A, zinc, iodine, Vitamin C and melatonin can each provoke underlying root cause factors in migraine. In these cases, using clinical indicators may be as helpful as serum levels. See the rationale for the Migraine Action Plan © (see below for access to Lesson 6) as a tool to tease out these factors as to how they may apply to you.

Consider a trial of the “Basic Four”

I found that between the literature support and my own clinical experience there are four front line nutrients that should be considered for every single patient with migraine. These would include magnesium, Vitamin D, riboflavin and CoQ10. This regimen is a simple, safe and relatively inexpensive approach to the management of nutrient deficits and their impact on migraines.

The study referenced above also included folate, and for that nutrient I would advise that every migraine patient have their homocysteine level checked at least one time to find out if their genetics fall short on activating their B vitamins, especially folate (as well as B6 and B12.)

I’ve posted part of my paid course Lesson 6: Integrative Therapy for Migraines for you to give some background and details on “The Basic Four.” Click the Lesson 6 link just above and after reading the first~10 paragraphs you will see the dosing details for those four key nutrients.

The “Basic Four” advice just scratches the surface of what you could learn about the real reasons you have migraine headaches and the specifics of non-drug therapy to alleviate them. Consider becoming a paid subscriber at only $7/month to get full subscriber benefits including unlimited access to the full Natural Migraine Relief for Women course.

This FAQs blog is free to all. Please share this information with a friend!

1. Gong P, et.al. Multiple vitamin deficiencies are associated with worse headache outcomes. Presented at the American Headache Society 66th Annual Scientific Meeting June 2024 San Diego, CA