Dear DOCTOR Owen:

I have had migraine headaches throughout my whole life and have been offered all types of drugs. I know that certain foods may contribute to migraines, but what about foods that prevent or treat them?

Headache

Dear “Headache”:

A recent review of the available literature found that two nutrients used in pharmacological doses reduced the frequency and severity of headaches: riboflavin (a B-complex vitamin) and magnesium (a mineral).

In one short-term study, a riboflavin dose of 400 milligrams/day for 12 weeks greatly reduced the frequency and severity (in 85% of the subjects) compared to the placebo. Riboflavin takes awhile to work, so don’t expect your headaches to disappear immediately. This dose is hard to find by itself in local health food stores. Generally speaking, B-complex vitamins are not stored in the body; instead they are excreted in the urine when administered in doses that are above the basic daily requirements.

It is not known why riboflavin appears to be useful. All vitamins administered in super-normal doses are not the same as the amounts usually acquired from foods. In super-normal doses, vitamins may affect enzyme systems and cells very differently. Some may even be toxic. No side effects of the riboflavin were reported in this study.

In another study, magnesium was found to greatly reduce headaches. Magnesium has many functions; it acts as a cell membrane stabilizer and is necessary for enzyme function. For decades, magnesium has been used as a blood pressure agent in pregnancy (toxemia), and the body can tolerate high doses of it. Magnesium deficiency can cause muscle weakness and lethargy, which usually result from diarrhea or the use of diuretic medication. Magnesium may help keep blood pressure measurements level in patients who are on medication for this condition.

In the study, the dose used for headaches was 600 milligrams/day, which is modest. An 80% reduction in migraine severity was reported. Even 2,500 milligrams/day are tolerated well.

Preparations with magnesium can be found with other minerals such as calcium, boron, selenium, and manganese; magnesium can also be found alone. Patients with kidney disease must be cautious with use, and those who are on other medications should check with their physicians and pharmacists about mixing magnesium with those preparations.