By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
If you look at a physician’s desk reference for treating migraines you will literally find an A to Z roster of medications – from Alsuma to Zomig…
Migraines – Beyond Drugs!
Myth: Get a migraine, treat it with a drug for relief.
Fact: There’s a world of help and healing beyond drugs.
A 1-2-3 nutritional supplement punch, along with a dose of Mother Earth, for relief.
To be sure, drugs are critical in the treatment of many conditions and I have often used them in my medical practice, and with great results. But I don’t agree with the concept that every single affliction under the sun has to be treated with a drug first. Keep in mind that all drugs have side effects, suppress and block certain biochemical pathways, and deplete the body of important nutrients. My mantra has generally been to try a safer, natural strategy first, and if that doesn’t work, then move on to drugs. I used that approach for my cardiac patients and also when dealing with other conditions, including migraine.
Migraine sufferers experience their headaches as intense pulsing or throbbing pain in one area of the head that can last 4-72 hours if untreated. Additional symptoms can include nausea and/or vomiting, or sensitivity to both light and sound. Migraine is three times more common in women than in men and affects more than 10 percent of people worldwide. Sometimes the onset is preceded by visual disturbances such as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by factors like stress, anxiety, hormonal changes, the menstrual cycle, bright or flashing lights, lack of food or sleep, and dietary substances.
A migraine story
If ever I encountered a damsel in distress it was a thirty-five-year-old patient who suffered from nasty, debilitating migraines. I prescribed a targeted nutritional supplement program for her, including known anti-migraine agents such as magnesium, riboflavin (vitamin B-2), and the herb feverfew. I had her tested for allergenic foods that might possibly cause artery-tightening reactions. She went off the foods and ingredients that could be particularly offending for her. She eliminated preservatives, dyes, and bacon and luncheon meats with nitrites and nitrates. I did a lot of research for her. At my recommendation, she even started eating an organic diet.
Despite a Herculean effort on her part, she reported that the relief was minimal. In 2005, a study was published by Swiss researchers indicating that CoQ10 could be helpful for migraines. I am a great champion of CoQ10, which is a superior antioxidant that also contributes directly to cellular energy production. I have recommended it routinely to my heart patients for decades.
But until I came across this new information I had no idea that CoQ10 could help this condition.
The research was done by headache experts at the University Hospital in Zurich. In their study, they randomly assigned 100 mg of CoQ10 or an inert placebo pill to 42 migraine sufferers. Over a period of three months, the frequency of the headaches decreased significantly among the CoQ10 takers but not among the placebo group. Approximately half of them experienced at least a 50 percent reduction in the frequency of attacks.
After reading the study, I contacted my patient and suggested she add CoQ10 to her regimen. She complied, and like magic, her symptoms went away almost entirely.
Later, during an office visit, she said that her migraines now lasted only a very short period of time and with much less intensity. Her improvement, she said, was better than 90 percent. She was a very happy camper.
The migraine-mitochondria connection
In recent years I have seen several research papers suggesting that migraines could be a result of impaired energy metabolism. In other words, the mitochondria of brain and nerve cells aren’t producing enough fuel. The mitochondria are the multiple structures inside cells that take oxygen and nutrients and turn them into ATP (adenosine triphosphate), the molecular fuel that keeps cells operating.
The mitochrondial connection makes sense to me. Poor mitochondrial function in the heart muscle and arterial walls is involved in many cardiovascular conditions. I’ve heard from a number of patients over the years that when I treated them for their heart problems their headaches improved, whether it was of the cluster, tension, or migraine type.
Another possibility for CoQ10 migraine effectiveness could be its great potency as an antioxidant that reduces high blood pressure. A recent Australian study, for instance, analyzed the results of multiple trials pitting CoQ10 against hypertension. The results showed that the supplement (at dosages from 34 to 225 mg a day) could drop blood pressure from 11-17 mmHg for systolic and 8-10 mmHg for diastolic). CoQ10 achieves that probably by reducing arterial oxidative stress that causes vasoconstriction. Can this be a mechanism for migraine? People become stressed, their blood pressure goes up, and the migraine develops. I’ve heard that from a number of patients.
However, until 2005 I had never connected migraine improvement specifically to CoQ10. I was thinking more that magnesium could be involved because it has a major relaxing effect on the body, including the arteries. Like CoQ10, it is also a major player in the ATP production sequence. Although the research indicates that magnesium can be effective against migraines, I have had only fair results with it alone. But together with CoQ10, the effect is powerfully synergistic.
I have also added riboflavin (vitamin B2) to the anti-migraine mix. Riboflavin has the potential to increase mitochondrial energy efficiency and, specifically, aid migraine sufferers. This effect was confirmed by a Belgian study back in 1994. In the trial, 45 patients were treated with 400 mg of riboflavin daily for three months with an approximate 68 percent improvement in symptoms. The researchers concluded that high-dose riboflavin offered an effective, low-cost treatment devoid of side effects.
Natural Remedies for Migraines
The combination of CoQ10, magnesium, and riboflavin is a potent 1-2-3 punch that can often knock out migraines. Take these three routinely, if you are a migraine sufferer.
● CoQ10 (preferably in the softgel form), 100-200 mg a day
● Magnesium (either in citrate, glycinate, taurinate, or orotate forms), 400 mg in divided doses
● Riboflavin (vitamin B2), 400 mg. One thing you may notice when you take riboflavin is that your urine will turn a bright yellow. It is nothing to be concerned about.
I would also recommend Earthing – and enthusiastically so. Earthing means reconnecting to the natural, subtle energy on the surface of the Earth by being barefoot outside or sleeping, relaxing, working indoors in contact with specially conductive sheets and mats that transfer the ground energy into your home or office. Earthing improves circulation and reduces inflammation, and can help combat migraine in the most natural way possible.
Lastly, nitrates and nitrites (additives in hotdogs, ham, frankfurters, bacon and sausages) have been reported to cause migraine headaches. Look for products without them. Try to eat as much fresh organic food as possible.
Q & A
Q: Can you treat migraines with food?
A: Yes – what and how you eat is a critical part of migraine management. First, since about 1/2 of all people who suffer from migraines get them after going without eating for too long, make sure to eat a series of small meals throughout the day to keep blood sugar from dropping too much. Also, there are certain “trigger” foods which affect approximately 40 percent of migraine sufferers that should be avoided, including cured meats, dried fruits, soy, aged cheeses and red wine, coffee, and foods containing MSG (monosodium glutamate). Lastly, there are several anti-migraine foods you should eat more of, such as cold-water fish (which contain omega-3s), those with magnesium (brown rice, oatmeal, kidney beans, chickpeas, lentils, Swiss chard, spinach, broccoli, and pumpkin seeds, to name a few), and foods like eggs and yogurt, which contain riboflavin. Try drinking ginger tea too.
- Rosenfeldt FL, Haas SJ, et al. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens, 2007; 21(4):297-306.
- Sandor PS, Di Clemente L, Coppola G, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology, 2005;64(4):713-5.
- Mauskop A, Altura BM. Role of magnesium in the pathogenesis and treatment of migraines. Clin Neurosci, 1998;5(1):24-7.
- Markley HG. CoEnzyme Q10 and riboflavin: the mitochondrial connection. Headache, 2012: 52 Suppl 2:81-7.
- Schoenen J, et al. High-dose riboflavin as a prophylactic treatment of migraine: results of an open pilot study. Cephalalgia, 1994;14(5):328-9.
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