In my last blog installment Migraines and Nutritional Support - Part 1 I briefly discussed some of the nutritional deficiencies and food triggers/sensitivities that may contribute to or be associated with the pathophysiology of migraine headaches. Correction of these deficiencies through appropriate supplementation while avoiding the triggers can greatly impact migraine frequency and intensity. In part two of this blog I will review some of the botanicals and other nutrients that have been shown in studies to help mitigate various aspects of migraines.

Ginkgo biloba is a medicinal herb that is known for its anti-platelet activity and traditionally has been used in a wide variety of applications including cerebral insufficiency and improving cognition and blood flow to the brain. One study showed that a complex of ginkgo combined with CoQ10 and vitamin B2 decreased the frequency and severity migraines. In another similar study using the previous combination with additional magnesium this time performed in school-aged children again migraine frequency was positively affected.

Therapeutic use of niacin which is typically associated with lipid modulation and cholesterol reduction appears to be useful for some individuals suffering with migraines.  Niacin plays an important role in the synthesis of tryptophan which is further metabolized in your brain into 5-HTP. 5-HTP stimulates the production of several neurotransmitters such as serotonin and dopamine. Low levels of tryptophan are commonly associated with a niacin deficiency and may lead to disturbances in the balance of brain neurotransmitters. As low levels of serotonin have been implicated as another factor in migraine generation is some individuals niacin supplementation could be a helpful prophylactic especially in a sustained release form.

Lipoic acid is a powerful antioxidant with useful applications in a variety of conditions including diabetic neuropathy and liver health. It is lipoic acid's antioxidative property that can help improve mitochondrial function thereby offsetting any mitochondrial generated oxidative stress. By addressing and improving mitochondrial function lipoic acid like CoQ10 (in part 1) was shown to decrease migraine frequency and severity in sufferers.

As for potential non-nutritive or herbal prophylaxis acupuncture appears to have a solid history both traditionally and in the scientific literature in helping migraineurs in this case against the standard prescription migraine medication flunarizine.

Chiropractic care which in the case of cervical spine instabilities helps re-establish anatomical and structural balance and thereby decreases associated cervical and cranial nerve irritation has also been shown to be useful in migraines.

Finally the medicinal herb feverfew has a long traditional history as a potential migraine preventative. And while the research is mixed I believe that in combination with some of the other compounds discussed in these blogs feverfew may prove to be a more potent and consistent prophylactic than what has been conveyed thus far.

Migraines are a ubiquitous malady and for many practitioners present difficult cases without resorting to more aggressive prescription medications. But perhaps by correcting diet and hormonal imbalances as well as addressing nutritional deficiencies we can yield improved outcomes for these patients and at the very least reduce the need for toxic medications.

Michael Fuhrman D.C.