Migraine Prevention—Basic Nutraceuticals
Adults with episodic migraine looking for evidence-based nutraceutical adjuncts (coordinate with clinician).
neurology
headache
preventive-care
reduce monthly migraine days
increase ≥50% responder rate
Core stack
Riboflavin (Vitamin B2)
B+
Form: riboflavin 400 mg
Dose: 400 mg/day
With breakfast
At least 3 months
Why: Guidelines and RCTs support prophylaxis with good tolerability.
Cautions
- Benign urine discoloration
- Rare GI upset
Magnesium (citrate/glycinate/oxide; elemental)
B
Form: elemental magnesium
Dose: 400–600 mg/day
Evening with food
8–12 weeks, then reassess
Why: Meta-analyses and trials show benefit for prevention with low risk.
Cautions
- Diarrhea with some salts
- Caution in renal disease
Coenzyme Q10
B-
Form: ubiquinone
Dose: 100–300 mg/day (split doses)
With meals
12 weeks
Why: Small RCTs and reviews suggest reduced attack frequency; well tolerated.
Cautions
- May lower warfarin effect
Adjuncts
Melatonin
C
Dose: 3 mg at bedtime
Nightly
Notes: Some trials show prophylactic benefit; may help sleep regularity.
Not recommended
- Unpurified butterbur (Petasites hybridus): Risk of hepatotoxic pyrrolizidine alkaloids unless PA-free Rx-grade
Monitoring
- Monthly migraine days
- Acute medication use
- Sleep duration/regularity