If you’re living with chronic migraine — meaning you have at least 15 migraine attacks each month — you’re not alone. More than 4 million adults in the U.S. have chronic migraine.
If prescription medications haven’t helped you, don’t lose hope. There’s a safe, alternative treatment that may help you get your life back — and it’s already part of your diet.
What Is Riboflavin?
Riboflavin — also known as vitamin B2 — helps your body turn carbohydrates, fats, and proteins into energy.
Found naturally in some foods, such as eggs, lean meats, nuts, dairy milk, and green, leafy vegetables, it is regularly added to grains and cereals.
How is riboflavin linked to migraine?
Doctors aren’t sure what causes migraine, but they believe they happen, in part, because of oxidative stress. That’s when there’s an imbalance between molecules that can damage your DNA (called free radicals) and those that can fight them off (antioxidants). This can cause inflammation throughout your body, including the brain or spinal cord (neuroinflammation).
Oxidative stress can also affect the body’s mitochondria. It makes the mitochondria stop working correctly (mitochondrial dysfunction). Since mitochondria are the “power sources” of each cell, when the mitochondria aren’t working correctly, they may not produce enough energy for the cells to function properly. These three things — neuroinflammation, oxidative stress, and mitochondrial dysfunction — can lead to migraine.
Riboflavin plays a key role in mitochondria formation. And it can help lower inflammation and oxidative stress.
Can Riboflavin Ease Migraine Symptoms?
Research suggests that riboflavin can ease migraine symptoms in adults.
In one study, patients who had migraines were given 400 milligrams of riboflavin each day for three months. After treatment, they experienced significantly fewer migraine attacks than they had previously. Their migraines were also less severe, lasted a shorter amount of time, and caused less nausea and vomiting.
In 2013, the American Academy of Neurology and American Headache Society updated their practice guidelines to state that riboflavin supplements are “probably effective and should be considered” to prevent migraines.
Danielle Wilhour, MD, a neurologist and headache specialist at UCHealth in Aurora, Colorado, suggests riboflavin to her patients to prevent migraines. She says it can be used alone or in combination with other supplements, such as vitamin B12, magnesium, or coenzyme Q10 (CoQ10), a compound your body makes to support mitochondria and protect cells. “The combination can increase the chance of migraine reduction, but that is perfectly fine if a person wanted to try it alone to start with,” she says. “Riboflavin can also be safely used in combination with many prescription medications.”
Melissa Moore, MD, a board-certified neurologist and headache specialist at Tampa General Hospital and USF Health in Tampa, Florida, says riboflavin is a good option if you’re looking for a more natural treatment or want to supplement your current prescription medications.
“We use riboflavin as a treatment on its own or combined with other supplements or prescription treatments,” Moore says. “This is a great option due to low side effects and good tolerability, as well.”
How is thiamine related to migraine?
Thiamine — also called B1 or thiamin — is a water-soluble vitamin that plays a key role in cell growth, development, and function. It helps break down glucose and turn carbohydrates into energy, mainly in the brain and nervous system. It’s found in whole grains, meat, fish, cereals, and bread.
Thiamine deficiency is rare, but if it does happen, it can cause neurological problems. It can also damage mitochondria, leading to mitochondrial dysfunction and inflammation of the nervous system, key factors in migraines.
Yet, research on thiamine as a migraine treatment — either alone or in combination with other vitamins, such as riboflavin — is limited. In one study, researchers tracked the migraine frequency of more than 13,000 patients and found a link between thiamine and migraines. Patients — especially women — who took higher doses of thiamine had fewer, less severe headaches than those who took lower doses. While studies suggest that thiamine may improve migraine symptoms, more research is needed.
What Are the Side Effects of Riboflavin?
Although riboflavin supplements are generally safe for most people, they can cause side effects. These may include the following:
- Discolored, yellow-orange urine
- Peeing more often and in higher amounts than normal (polyuria)
- Diarrhea, nausea, or stomach cramps
Side effects are rare. Because your body can only absorb 27 milligrams of riboflavin at a time, you really can’t take too much of it. Any riboflavin your body doesn’t use will come out in your pee.
Does riboflavin interfere with medications?
Some drugs can interact with riboflavin or make it less effective.
Interactions with these drugs are more likely if you take higher doses of riboflavin:
- Doxorubicin (a chemotherapy drug)
- Tetracycline (an antibiotic)
These medications can make riboflavin less effective:
- Anticholinergics, which may be used to treat Parkinson’s disease, urinary incontinence, or excessive sweating
- Phenothiazines, which may be used to treat mental or emotional disorders
- Some anti-seizure medications, such as phenytoin
Before taking riboflavin, talk to your doctor about other medications you take that may interfere with it.
How to Choose a Riboflavin Supplement
Most people in the U.S. get enough riboflavin in their diet, and deficiency is very rare. But if you decide to take a riboflavin supplement to treat your migraine, you can find it in different forms. It’s available in multivitamin and mineral supplements, B-complex dietary supplements, and riboflavin-only supplements.
Both Moore and Wilhour recommend taking a total dose of 400 milligrams of riboflavin per day for the treatment of migraine. “Some stores and vitamin shops do not carry this specific product and dose, so it may need to be purchased online,” Wilhour says.
You can take your riboflavin supplement as a single dose once a day or as two 200-milligram doses. Take it with meals, as food helps your body absorb nutrients better, and drink a full glass of water with each dose.
What an expert says
Wilhour says that if you decide to add riboflavin supplements to your migraine treatment plan, keep in mind that supplements are not regulated by the FDA. “I do encourage patients to select supplements from reputable manufacturers due to lack of FDA regulation and variability in product quality,” Wilhour says.
Whether you buy supplements from a store or online, follow these tips to check them:
- Look up ingredients or those you don’t recognize on the FDA website.
- Check for an approved, third-party certification seal on the product label.
- Choose supplements with fewer than six ingredients on the label.
- If you need recommendations, ask your doctor or pharmacist.
