People who suffer from frequent migraines are often drawn to herbal remedies and vitamin or mineral supplements, and understandably so. The headaches themselves can be debilitating, and the prescription drugs sometimes used to prevent them — including certain antidepressants, beta blockers and calcium channel blockers — don't always work and often cause side effects.
Unfortunately, evidence to support the alternative treatments is generally poor, and some of them may pose their own risks. And, as with all dietary supplements, there's no guarantee that what's on the label is actually in the bottle, since oversight by the Food and Drug Administration is minimal at best. Look for products labeled "USP Verified," which have been tested by the U.S. Pharmacopeia for purity and potency.
Here's Consumer Reports' take on five commonly used migraine supplements.
· Butterbur: An extract made from the root of this plant has been used medicinally for centuries. A 2004 study found that 75 milligrams of it taken twice daily worked better than a placebo, and suggested it might even be as effective as prescription drugs in reducing the frequency, intensity and duration of migraines. Adverse reactions include burping, fatigue, itchiness and stomach problems. Some butterbur products contain chemicals called unsaturated pyrrolizidine alkaloids, which can harm the liver. So only use those labeled "hepatotoxic PA-free," which claim not to include that substance.
· Coenzyme Q10: The body's cells make this substance, often called CoQ10. In one small study, taking 150 milligrams per day cut the number of days with migraines in half in most of the patients. Another study found similar results with 100 milligrams taken three times daily.
· Feverfew: The dried leaves of this weed have been used to ease headaches for centuries. And some research suggests that extracts of it reduce the frequency of migraines and ease the nausea, pain, vomiting and sensitivity to light and sound that they can cause. But others have found that feverfew is no better than a placebo. Most studies have used 50 to 100 milligrams of feverfew extract daily. It seems to be generally well tolerated, though in a few cases it may cause stomach problems and joint stiffness.
· Magnesium: Some research suggests that migraine sufferers have low levels of this mineral in their brain. But studies that have used magnesium supplements to treat or prevent attacks have yielded mixed results. Common side effects are gastrointestinal, mainly diarrhea. Foods high in magnesium include fish, leafy green vegetables, nuts, and whole grains.
· Riboflavin: In a trial of 55 people with migraines, researchers gave half of them a daily 400 milligram dose of this B vitamin and the other half a placebo. After three months, more than half of those taking the vitamin showed substantial improvements, compared with 15 percent of those taking the placebo. Side effects can include diarrhea and frequent urination. And high intakes may cause yellow-orange urine. Foods high in riboflavin include cheese, leafy green vegetables, meat, milk, yogurt, and enriched grains.
For more information on these and other dietary supplements, including medications they might interact with, go to http://www.consumerreportshealth.org/ and click on the "Natural Health" tab.