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Natural Headache Remedies

October 30, 2009 Written by JP    [Font too small?]

Alternative remedies are generally best suited for the management of chronic conditions. On the other hand, acute symptoms and medical emergencies frequently require conventional care. If you break a leg, going to the hospital obviously makes much better sense than treating it with guided imagery and an herbal poultice. But with non-life threatening conditions such as recurrent headaches, the side effects associated with long term medication often make natural remedies a more attractive option.

In the past few months there have been several promising studies about a variety of holistic treatments for chronic headaches. Please keep in mind that I’ve only selected a handful of the newest published trials. (1)

Headache Remedy #1 – Body Therapies

A recent survey discovered that chiropractic was the most popular alternative therapy for “chronic tension type headaches”. The problem that many physicians have with this form of treatment is that there aren’t many well designed studies that prove its efficacy and safety in those with this variety of pain. However, a new study appearing in the Journal of Manipulative Physiological Therapeutics helps to strengthen the case for chiropractic adjustments in the treatment of tension headaches.

  • Participants with at least 10 tension related headaches per month were included in the research. Headache symptoms were recorded for 4 weeks prior to the trial and 14 weeks later, at its conclusion.
  • Four groups were established: a) chiropractic + medication; b) chiropractic + placebo; c) sham chiropractic + medication; d) sham chiropractic + placebo.

Those receiving the combination therapy of chiropractic + medication demonstrated a significant reduction in headache frequency. While promising, the researchers are calling for additional study with a larger pool of participants. (2,3,4,5,6)

A form of body manipulation known as trigger point therapy may also benefit those with “tension-type headaches”. A recent scientific review describes trigger points as “discrete, focal, hyper-irritable spots located in a taut band of skeletal muscle”. Administering analgesic (pain relieving) injections or carefully applied massage to these locations can often relieve chronic pain. This fact is evidenced by a few recent studies. The latest of which involved 9 adolescent females with tension-type headaches. All of the participants were administered twice-weekly “trigger point specific physiotherapy”. Dramatic improvements in headache duration (77%), frequency (68%) and intensity (74%) were reported after about 7 sessions. No adverse effects were documented. A 2008 study from Spain also found impressive success rates in a larger and more diverse group of study volunteers. (7,8,9)

Headache Remedy #2 – Mind-Body Therapies

Kiko, a Japanese martial arts practice that involves “repetitive coordinated breath and movement”, was recently found to significantly reduce migraine symptoms in a small group of headache sufferers. Baseline and post-trial migraine symptoms were rated and recorded. The participants were taught Kiko in 3 monthly sessions and then practiced it at home using an instructional DVD. Only about half of the study volunteers completed the 4 month trial. But all of those who did experienced “measurable improvement in their migraines” with “no reported adverse effects”. I’m mentioning the relatively high “drop out” rate because this is an important consideration when choosing any kind of treatment. The fact is that many natural remedies require more effort and persistence than simply popping a prescribed capsule or tablet. (10)

Two new studies support the use of acupuncture in patients with both acute and chronic migraines. The first trial appears in the June edition of the journal Headache. 175 migraine sufferers were divided into 3 groups – a treatment group, which received verum (real) acupuncture and two “sham” acupuncture groups. The pain relieving effects of the respective treatments were measured 1/2 hour, 1 hour, 2 hours and 4 hours post application. The researchers also monitored the degree of “aggravation”, pain and relapse in the subsequent 24 hour period. The authors of the study noted that real acupuncture, “is more effective than sham acupuncture … in reducing the discomfort of acute migraine. Verum acupuncture is also clearly effective in relieving pain and preventing migraine relapse”. A separate study from April 2009 determined that directing acupuncture at the gallbladder and liver meridians (specific acupuncture points) may be more effective and safer than conventional medication in the long term (chronic) management of migraines. The patients in that trial were followed for a total of 1.5 years. (11,12)

Common Trigger Points Associated with Headache Pain
Headache Remedy #3 – Kampo (Japanese Herbal Medicine)

There are some people out there who have tried numerous conventional and natural treatments to alleviate chronic headaches and have been unsuccessful. Sometimes they’ve been to the most respected experts in the field and have even tried the most rigorous alternative options available. To those individuals I say: Please don’t give up! There are always avenues that are left to be explored. An example can be found in the July edition of the Journal of Alternative and Complementary Medicine. A case study is presented about a 13 year old girl who is physiologically healthy but has been suffering from headaches since the age of 11. After a thorough holistic evaluation, a specific Japanese (Kampo) herbal remedy known as saikokaryukotsuboreito was prescribed. The young lady found acute relief as long as she remembered to take her “medicine”. After 11 months of treatment, the use of the herbal remedy was discontinued. The headache did not recur after that based on a 3 year follow up evaluation. The authors of this case study commented that, “Kampo formulas are selected not only by paying attention to the primary symptom but also by checking the other characteristics (symptoms, constitution, etc.)”. Previous experiments using another Kampo herbal medicine (goshuyuto) have also noted success in larger study groups. (13,14,15)

It’s vitally important to have options in health care. No one therapy is right for everyone – whether natural, synthetic or something in between. Human beings are not a “one size fits all” kind of organism. We’re unique in our physiological and psychological make up and, therefore, require an individualized medical approach. But if we’re not aware of the available options, they don’t practically exist. If Kampo just sounds like a foreign word and trigger point therapy brings a gun to mind, then it’s highly unlikely that you’ll ever have the opportunity to benefit from these potentially life changing treatments. This is part of the reason why I’m so happy to be able to research these and other topics and share them with you.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Alternative Therapies, Nutritional Supplements

26 Comments & Updates to “Natural Headache Remedies”

  1. Nina K. Says:


    i love those japanese and chinese herbal issues. we do know so less about natures medicine cabinet. thanks for bringing those issues on top.

    ….and – im late – i wish you and yours a nice weekend and scary halloween 🙂 😉

    Nina K.

  2. JP Says:


    I completely agree. I love learning about traditional remedies that are foreign to me. In fact, I was just reading about how researchers are currently (re)discovering traditional healing techniques from Iran. Really fascinating, I think.


    A happy and scary (belated) Halloween to you and yours! 🙂 I hope you all had a wonderful weekend!

    Be well!


  3. Angie Says:

    There are times when I go in with a throbbing head to my chiropractor and I leave floating away.

    Now that I go to her, I do not know how I ever did not go.

    Awesome article, as always!

    I love all of this information on natural remedies.

  4. JP Says:

    Thanks, Angie! 🙂

    I’m thrilled to hear that chiropratic is helping you. I went to a chiropractic a few years ago after a car crash. I think it really helped me to recover 100%.

    Be well!


  5. Ashley C. Says:

    I used to get headaches, it was from stress.

  6. Giri Says:


    I wanted to share this and this has worked atleast 5 times so far for me and my wife, For headache we have 2 packets of emergenC(1000 mg) each and 3 lemons and add a little stevia and ice and make a drink and within minutes the headaches would disappear. tried and tested, hence wanted to share



  7. JP Says:

    Thanks for sharing that, Giri! I rarely get headaches. But, I wouldn’t hesitate trying your remedy when and if I do. I’d also love to receive feedback from anyone who tries your recipe.

    FYI, there is some validation for the use of Vitamin C combined with other antioxidants for headaches in the medical literature. Here are a few examples:


    “Fifty outpatients with chronic migraine refractory to at least two prophylactic medications were treated with an antioxidant formulation of 1200 mg Pinus radiata bark extract and 150 mg vitamin C daily for 3 months…

    …data suggest that the antioxidant therapy used in this study may be beneficial in the treatment of migraine possibly reducing headache frequency and severity.”


    “Twelve patients with a long-term history of migraine with and without aura who had failed to respond to multiple treatments with beta-blockers, antidepressants, anticonvulsants, and 5-hydroxytryptamine receptor agonists were selected for the study. They were treated with 10 capsules of an antioxidant formulation of 120 mg pine bark extract, 60 mg vitamin C, and 30 IU vitamin E in each capsule daily for 3 months…

    … ata suggest that the antioxidant therapy used in this study may be beneficial in the treatment of migraine possibly reducing headache frequency and severity. Further clinical investigation into the efficacy of antioxidant as therapy for chronic migraine is warranted.”

    Be well!


  8. JP Says:

    Update: EFT, a mind-body therapy, may be helpful …


    Explore (NY). 2013 Mar-Apr;9(2):91-9.

    Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial.

    OBJECTIVE: To evaluate the short-term effects of the emotional freedom technique (EFT) on tension-type headache (TTH) sufferers.

    DESIGN: We used a parallel-group design, with participants randomly assigned to the emotional freedom intervention (n = 19) or a control arm (standard care n = 16).

    SETTING: The study was conducted at the outpatient Headache Clinic at the Korgialenio Benakio Hospital of Athens.

    PARTICIPANTS: Thirty-five patients meeting criteria for frequent TTH according to International Headache Society guidelines were enrolled.

    INTERVENTION: Participants were instructed to use the EFT method twice a day for two months.

    OUTCOME MEASURES: Study measures included the Perceived Stress Scale, the Multidimensional Health Locus of Control Scale, and the Short-Form questionnaire-36. Salivary cortisol levels and the frequency and intensity of headache episodes were also assessed.

    RESULTS: Within the treatment arm, perceived stress, scores for all Short-Form questionnaire-36 subscales, and the frequency and intensity of the headache episodes were all significantly reduced. No differences in cortisol levels were found in any group before and after the intervention.

    CONCLUSIONS: EFT was reported to benefit patients with TTH. This randomized controlled trial shows promising results for not only the frequency and severity of headaches but also other lifestyle parameters.

    Be well!


  9. JP Says:

    Update: Mindfulness meditation offers another mind-body approach to reducing headache pain …


    Nurs Midwifery Stud. 2014 Sep;3(3):e21136. Epub 2014 Sep 20.

    Effect of mindfulness-based stress reduction on pain severity and mindful awareness in patients with tension headache: a randomized controlled clinical trial.

    BACKGROUND: Programs to improve the pain and health status in illnesses with pain such as headache are still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain.

    OBJECTIVES: This study evaluated efficacy of MBSR in improving pain severity and mindful awareness in patients with tension headache.

    PATIENTS AND METHODS: This study was a randomized controlled clinical trial that was conducted in 2012 in Shahid Beheshti Hospital of Kashan City. Sixty patients who were diagnosed with tension-type headache according to the International Headache Classification Subcommittee were randomly assigned to treatment as usual (TAU) or MBSR groups. The MBSR group received eight weekly treatments. Any session lasted 120 minutes. The sessions were based on MBSR protocol. Diary scale for measuring headache and Mindful Attention Awareness Scale (MAAS) were administered at pretreatment, and posttreatment, and three-month follow-up in both groups. The data was analyzed using repeated measures analysis of variance.

    RESULTS: The mean of pain severity was 7.36 ± 1.25 before intervention that was significantly reduced to 5.62 ± 1.74 and 6.07 ± 1.08 after the intervention and follow-up (P < 0.001). In addition, the MBSR group showed higher scores in mindful awareness in comparison with the control group at posttest session. The mean of mindful awareness before intervention was 34.9 ± 10.5 and changed to 53.8 ± 15.5 and 40.7 ± 10.9 after the intervention and follow-up sessions (P < 0.001). CONCLUSIONS: MBSR could reduce pain and improve mindfulness skills in patients with tension headache. It appears that MBSR is an effective psychotherapy for treatment of patients with tension headache. Be well! JP

  10. JP Says:

    Update 05/06/15:


    J Headache Pain. 2015 Dec;16(1):516.

    Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial.

    BACKGROUND: Non-medical, non-pharmacological and pharmacological treatments are recommended for the prevention of migraine. The purpose of this randomized double-blind placebo controlled, multicenter trial was to evaluate the efficacy of a proprietary nutritional supplement containing a fixed combination of magnesium, riboflavin and Q10 as prophylactic treatment for migraine.

    METHODS: 130 adult migraineurs (age 18 – 65 years) with ≥ three migraine attacks per month were randomized into two treatment groups: dietary supplementation or placebo in a double-blind fashion. The treatment period was 3 months following a 4 week baseline period without prophylactic treatment. Patients were assessed before randomization and at the end of the 3-month-treatment-phase for days with migraine, migraine pain, burden of disease (HIT-6) and subjective evaluation of efficacy.

    RESULTS: Migraine days per month declined from 6.2 days during the baseline period to 4.4 days at the end of the treatment with the supplement and from 6.2.days to 5.2 days in the placebo group (p = 0.23 compared to placebo). The intensity of migraine pain was significantly reduced in the supplement group compared to placebo (p = 0.03). The sum score of the HIT-6 questionnaire was reduced by 4.8 points from 61.9 to 57.1 compared to 2 points in the placebo-group (p = 0.01). The evaluation of efficacy by the patient was better in the supplementation group compared to placebo (p = 0.01).

    CONCLUSIONS: Treatment with a proprietary supplement containing magnesium, riboflavin and Q10 (Migravent® in Germany, Dolovent® in USA) had an impact on migraine frequency which showed a trend towards statistical significance. Migraine symptoms and burden of disease, however, were statistically significantly reduced compared to placebo in patients with migraine attacks.

    Be well!


  11. JP Says:

    Update 06/11/15:


    Evid Based Complement Alternat Med. 2015;2015:920353.

    Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up.

    Objectives. This study aimed to evaluate the efficacy and safety of manual acupuncture as a prophylaxis for frequent migraine. Methods. Fifty frequent migraineurs were randomly allocated to receive 16 sessions of either real acupuncture (RA = 26) or sham acupuncture (SA = 24) during 20 weeks. The primary outcomes were days with migraine over four weeks, duration, and intensity of migraine and the number of responders with more than 50% reduction of migraine days. The secondary outcomes were the relief medication, quality of migraine, quality of life, and pressure pain thresholds. Results. The two groups were comparable at baseline. At the end of the treatment, when compared with the SA group, the RA group reported significant less migraine days (RA: 5.2 ± 5.0; SA: 10.1 ± 7.1; P = 0.008), less severe migraine (RA: 2.18 ± 1.05; SA: 2.93 ± 0.61; P = 0.004), more responders (RA: 19 versus SA: 7), and increased pressure pain thresholds. No other group difference was found. Group differences were maintained at the end of the three-month follow-up, but not at the one-year follow-up. No severe adverse event was reported. Blinding was successful. Discussion. Manual acupuncture was an effective and safe treatment for short-term relief of frequent migraine in adults. Larger trials are warranted.

    Be well!


  12. JP Says:

    Updated 03/07/16:


    J Res Med Sci. 2015 Nov;20(11):1058-63.

    Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache.

    BACKGROUND: Programs for improving health status of patients with illness related to pain, such as headache, are often still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain and stress. This study evaluated efficacy of MBSR in treatment of perceived stress and mental health of client who has tension headache.

    MATERIALS AND METHODS: This study is a randomized clinical trial. Sixty patients with tension type headache according to the International Headache Classification Subcommittee were randomly assigned to the Treatment As Usual (TAU) group or experimental group (MBSR). The MBSR group received eight weekly classmates with 12-min sessions. The sessions were based on MBSR protocol. The Brief Symptom Inventory (BSI) and Perceived Stress Scale (PSS) were administered in the pre- and posttreatment period and at 3 months follow-up for both the groups.

    RESULTS: The mean of total score of the BSI (global severity index; GSI) in MBSR group was 1.63 ± 0.56 before the intervention that was significantly reduced to 0.73 ± 0.46 and 0.93 ± 0.34 after the intervention and at the follow-up sessions, respectively (P < 0.001). In addition, the MBSR group showed lower scores in perceived stress in comparison with the control group at posttest evaluation. The mean of perceived stress before the intervention was 16.96 ± 2.53 and was changed to 12.7 ± 2.69 and 13.5 ± 2.33 after the intervention and at the follow-up sessions, respectively (P < 0.001). On the other hand, the mean of GSI in the TAU group was 1.77 ± 0.50 at pretest that was significantly reduced to 1.59 ± 0.52 and 1.78 ± 0.47 at posttest and follow-up, respectively (P < 0.001). Also, the mean of perceived stress in the TAU group at pretest was 15.9 ± 2.86 and that was changed to 16.13 ± 2.44 and 15.76 ± 2.22 at posttest and follow-up, respectively (P < 0.001). CONCLUSION: MBSR could reduce stress and improve general mental health in patients with tension headache. Be well! JP

  13. JP Says:

    Updated 03/22/16:


    Funct Neurol. 2016 Mar 8:1-5.

    Melatonin 4 mg as prophylactic therapy for primary headaches: a pilot study.

    There is growing evidence that headaches are connected to melatonin secretion. Our aim was to assess the potential effectiveness of melatonin for primary headache prevention. Forty-nine patients (37 with migraine and 12 with chronic tension-type headache, TTH) were prescribed oral melatonin, 4 mg, 30 minutes before bedtime for six months. Forty-one (83.6%) of the 49 patients completed the study, while eight dropped out for personal reasons. A statistically significant reduction in headache frequency was found between baseline and final follow-up after six months of treatment (p=0.033 for TTH patients and p<0.001 for migraineurs). The Headache Impact Test score was significantly reduced in both groups of headache patients (p=0.002 and p<0.001, respectively). At baseline, melatonin levels, measured both during a headache attack and a pain-free period, did not differ between patients with TTH and migraineurs (p=0.539 and p=0.693, respectively), and no statistically significant differences in Hamilton Depression Rating Scale scores were found between the two groups. Melatonin 4 mg as prophylactic therapy for primary headaches: a pilot study This pilot study shows promising results, in terms of headache frequency reduction and daily quality of life improvement, in both groups.

    Be well!


  14. JP Says:

    Updated 06/06/16:


    Schmerz. 2016 Jun;30(3):295-310.

    [Peppermint oil in the acute treatment of tension-type headache].

    Tension-type headache is the most frequent form of headache. The local topical treatment with peppermint oil (oleum menthae piperitae) has proven to be significantly more effective than placebo in controlled studies. Peppermint oil targets headache pathophysiology in multiple ways. The efficacy is comparable to that of acetylsalicylic acid or paracetamol. Solutions of 10 % peppermint oil in ethanol are licensed for the treatment of tension-type headache in adults and children above 6 years. It is included in treatment recommendations and guidelines by the respective professional societies and is regarded as a standard treatment for the acute therapy of tension-type headaches.

    Be well!


  15. JP Says:

    Updated 06/26/16:


    Neurol Sci. 2016 Jun 23.

    The efficacy of lymphatic drainage and traditional massage in the prophylaxis of migraine: a randomized, controlled parallel group study.

    This study aimed at examining the efficacy of lymphatic drainage (LD) and traditional massage (TM) in the prophylactic treatment of migraine using controlled prospective randomized clinical trial of 64 patients (57 women, 45 ± 10 years) with migraine with and without aura. Patients were randomized into three groups: LD (n = 21); TM (n = 21); waiting group (WG, n = 22). After a 4-week-baseline, a treatment period of 8 weeks was applied followed by a 4-week observation period. The patients filled in a headache diary continuously; every 4 weeks they filled in the German version of the CES-D and the German version of the Headache Disability Inventory. The main outcome measure was migraine frequency per month. At the end of the observation period, the number of migraine attacks and days decreased in the LD group by 1.8 and 3.1, respectively, in the TM group by 1.3 and 2.4, and in the WG by 0.4 and 0.2, respectively. The differences between LD and WG were significant (p = 0.006 and p = 0.015, respectively) as well as the differences between TM und WG (p = 0.042 and p = 0.016, respectively). There was a significant decrease in the amount of analgesic intake in the LD group compared to the two other groups (p = 0.004). TM and LD resulted in a reduction of migraine attack frequency. The analgesic intake only decreased significantly during LD intervention. Useful effects were identified for LD and TM as compared to WG for the prophylaxis of migraine. LD was more efficacious in some parameters than TM.

    Be well!


  16. JP Says:

    Updated 02/07/17:


    Discussion: Drug-resistant CH is one of the greatest challenges in headache medicine, and new therapeutic options are welcome. Our observation suggests that ketogenesis can also help CH patients other than migraineurs, maybe by modulation of cortical excitability, or by dampening neural-inflammation. It is interesting to note that both CH and migraine are headache forms that involve the trigeminovascular system, maybe the real target of ketogenesis in headache patients.

    Be well!


  17. JP Says:

    Updated 03/12/17:


    Neurol Sci. 2017 Mar 10.

    Single-blind, randomized, pilot study combining shiatsu and amitriptyline in refractory primary headaches.

    Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for primary headaches. However, evidence-based data about the effect of combining shiatsu and pharmacological treatments are still not available. Therefore, we tested the efficacy and safety of combining shiatsu and amitriptyline to treat refractory primary headaches in a single-blind, randomized, pilot study. Subjects with a diagnosis of primary headache and who experienced lack of response to ≥2 different prophylactic drugs were randomized in a 1:1:1 ratio to receive shiatsu plus amitriptyline, shiatsu alone, or amitriptyline alone for 3 months. Primary endpoint was the proportion of patients experiencing ≥50%-reduction in headache days. Secondary endpoints were days with headache per month, visual analogue scale, and number of pain killers taken per month. After randomization, 37 subjects were allocated to shiatsu plus amitriptyline (n = 11), shiatsu alone (n = 13), and amitriptyline alone (n = 13). Randomization ensured well-balanced demographic and clinical characteristics at baseline. Although all the three groups improved in terms of headache frequency, visual analogue scale score, and number of pain killers (p < 0.05), there was no between-group difference in primary endpoint (p = ns). Shiatsu (alone or in combination) was superior to amitriptyline in reducing the number of pain killers taken per month (p < 0.05). Seven (19%) subjects reported adverse events, all attributable to amitriptyline, while no side effects were related with shiatsu treatment. Shiatsu is a safe and potentially useful alternative approach for refractory headache. However, there is no evidence of an additive or synergistic effect of combining shiatsu and amitriptyline. These findings are only preliminary and should be interpreted cautiously due to the small sample size of the population included in our study. Be well! JP

  18. JP Says:

    Updated 05/10/17:


    Immunogenetics. 2017 May 6.

    The synergistic effects of ω-3 fatty acids and nano-curcumin supplementation on tumor necrosis factor (TNF)-α gene expression and serum level in migraine patients.

    Migraine is a destabilizing neuroinflammatory disorder characterized by recurrent headache attacks. Evidences show tumor necrosis factor (TNF)-α play a role in neuroimmunity pathogenesis of migraine. TNF-α increase prostanoid production, hyperexcitability of neurons, and nociceptor activation resulted in neuroinflammation and neurogenic pain. ω-3 fatty acids and curcumin exert neuroprotective and anti-inflammatory effects via several mechanisms including suppression of TNF-α gene expression and its serum levels. The aim of this study is an evaluation of synergistic effects of ω-3 fatty acids and nano-curcumin on TNF-α gene expression and serum levels in migraine patients. The present study performed as a clinical trial over a 2 month period included 74 episodic migraine patients in 4 groups and received ω-3 fatty acids, nano-curcumin, and combination of them or placebo. At the start and the end of the study, the gene expression of TNF-α and TNF-α serum levels was measured by real-time PCR and ELISA method, respectively. Our results showed that the combination of ω-3 fatty acids and nano-curcumin downregulated TNF-α messenger RNA (mRNA) significantly in a synergistic manner (P < 0.05). As relative to gene expression, a significant greater reduction in serum levels of TNF-α were observed in the combination group, but no significant differences in other groups. Supplementation with ω-3 fatty acids or nano-curcumin alone did not show significant reduction either in mRNA or serum levels of TNF-α. In addition, a much greater reduction in attack frequency was found in the combination group (P < 0.001). These findings indicated that ω-3 fatty acids and curcumin supplementation can be considered as a new promising approach in migraine management. Be well! JP

  19. JP Says:

    Updated 07/01/17:


    Nutr Neurosci. 2017 Jun 30:1-10.

    Effects of omega-3 fatty acids on the frequency, severity, and duration of migraine attacks: A systematic review and meta-analysis of randomized controlled trials.

    The present systematic review with meta-analysis of randomized controlled trials (RCTs) aimed to analyze the effectiveness of omega-3 fatty acids on the frequency, severity, and duration of migraine. This systematic review was performed by searching several databases for controlled clinical trials. Of the 13 trials, five, two, and three RCTs met the eligibility criteria to evaluate the efficacy of omega-3 on the frequency, duration, and severity of migraine attacks, respectively. The Jadad scale was used to evaluate the risk of bias analysis. Overall estimates of the intervention effect were obtained from random-effect meta-analysis. The studies’ heterogeneity was evaluated using the chi-squared test (χ2) (Cochran’s test (Q test)) and I2 Index. Potential sources of heterogeneity among the trials were investigated by meta-regression analyses. The results showed that omega-3 intake had no effect on frequency (WMD = -0.20; 95%CI -0.67, 0.27; P = 0.401, and I2 = 4.6%; P = 0.380) and severity (SMD = -0.59; 95%CI -1.85, 0.66; P = 0.35, and I2 = 88.8%; P = 0.000) of migraine but had a reduction effect on the duration of migraine attacks (WMD = -3.44; 95%CI -5.70, -1.19; P = 0.003, and I2 = 0.0%; P = 0.926). In conclusion, omega-3 intake leads to a significant reduction of approximately 3.44 hours in the duration of migraine. Further randomized controlled trials of high methodological quality with adequate sample sizes are required to confirm the results of the meta-analyses.

    Be well!


  20. JP Says:

    Updated 10/03/17:


    Musculoskelet Sci Pract. 2017 Aug 14;32:38-43.

    Effect of resistance training on headache symptoms in adults: Secondary analysis of a RCT.

    BACKGROUND: While strength training for the neck and shoulder muscles may be effective in reducing headache, the optimal combination of exercise frequency and duration is unknown. This study investigates the effect of different time-wise combinations of one weekly hour of strength training for the neck and shoulder muscles on headache frequency, intensity, and use of analgesics.

    METHODS: A total of 573 office workers were randomly allocated at the cluster-level to five groups; 3 × 20 min a week of minimally supervised (3MS), 1 × 60 (1WS), 3 × 20 (3WS) or 9 × 7 (9WS) min a week of supervised high-intensity strength training for 20 weeks, or to a reference group without training (REF). Headache frequency, intensity, and use of analgesics in relation to headache were determined by questionnaire at baseline and follow-up.

    RESULTS: The intention-to-treat analysis showed reduced headache frequency and intensity of approximately 50% in all training groups compared with REF at 20-week follow-up (P < 0.001). Use of analgesics was lower in the supervised training groups (1WS, 3WS and 9WS), but not in the group with minimal training supervision (3MS), compared with REF at follow-up.

    CONCLUSION: One hour of specific strength training – regardless of the distribution during the week – effectively reduced both headache frequency and intensity in office workers. Thus, a large time-wise flexibility exists when implementing specific strength training at the workplace. However, only supervised training led to a reduction in use of analgesics for headache.

    Be well!


  21. JP Says:

    Updated 06/26/18:


    CNS Neurol Disord Drug Targets. 2018 Jun 24.

    A novel combination of ω-3 fatty acids and nano-curcumin modulates interleukin-6 gene expression and high sensitivity C-reactive protein serum levels in patients with migraine: a randomized clinical trial study.

    BACKGROUND: Migraine is a disabling neuroinflammatory condition characterized by increasing the levels of interleukin (IL)-6, a proinflammatory cytokine and C-reactive protein (CRP) which considered as a vascular inflammatory mediator, disrupting the integrity of blood-brain barrier and contributing to neurogenic inflammation, and disease progression. Curcumin and ω-3 fatty acids can exert neuroprotective effects through modulation of IL-6 gene expression and CRP levels. The aim of present study is the evaluation of combined effects of ω-3 fatty acids and nano-curcumin supplementation on IL-6 gene expression and serum level and hs-CRP levels in migraine patients.

    METHODS: Eighty episodic migraine patients enrolled in the trial and were divided into four groups as 1) combination of ω-3 fatty acids (2500 mg) plus nano-curcumin (80 mg), 2) ω-3 (2500 mg), 3) nano-curcumin (80 mg), and 4) the control (ω-3 and nano-cucumin placebo included oral paraffin oil) over a two-month period. At the beginning and the end of the study, the expression of IL-6 from peripheral blood mononuclear cells and IL-6 and hs-CRP serum levels were measured, using a real-time PCR and ELISA methods, respectively.

    RESULTS: The results showed that both of ω-3 and nano-curcumin down-regulated IL-6 mRAN and significantly decreased the serum concentration. hs-CRP serum levels significantly decrease in combination and nano-curcumin within groups (P<0.05). An additive greater reduction of IL-6 and hs-CRP was observed in the combination group suggested a possible synergetic relation.

    CONCLUSION: It seems that, ω-3 fatty acids and curcumin supplementation can be considered a new promising target in migraine prevention.

    Be well!


  22. JP Says:

    Updated 08/15/18:


    Prostaglandins Leukot Essent Fatty Acids. 2018 Aug;135:47-53.

    Long-chain omega-3 fatty acids and headache in the U.S. population.

    The objective of this study was to assess whether dietary intake of long-chain omega-3 polyunsaturated fatty acids (PUFAs) is associated with lower prevalence of headache in the U.S.

    POPULATION: This cross-sectional study used data for a nationally representative sample of 12,317 men and women aged ≥ 20 years participating in the National Health and Nutrition Examination Surveys of 1999-2004. Interviewers recorded self-report of severe headache or migraine in the past three months. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were quantified from 24-hour dietary recall using the U.S. Department of Agriculture National Nutrient Database. Serum concentration of C-reactive protein, a marker of inflammation and potential mediator of PUFA’s analgesic properties, was quantified by latex-enhanced nephelometry. Multivariable generalized linear models estimated prevalence ratios (PR) with 95% confidence limits (CL) for severe headache or migraine adjusting for NHANES cycle, sociodemographic characteristics, body mass index and total energy intake. The unadjusted prevalence of severe headache or migraine was 22.0% (females 28.2%, males 15.5%). In multivariable analysis, greater intake of omega-3 PUFAs was associated with lower prevalence of severe headache or migraine: PR 0.94 (95% CL: 0.88, 0.99, p = 0.035) per log unit increase in EPA, and PR 0.94 (95% CL: 0.90, 0.99, p = 0.023) per log unit increase in DHA. The strength of association was greater for non-Mexican Hispanics than for other racial/ethnic groups but was not attenuated after adjustment for C-reactive protein. In conclusion, higher dietary intakes of EPA and DHA were associated with lower prevalence of headache supporting the hypothesis that omega-3 PUFAs may prevent or reduce headache.

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  23. JP Says:

    Updated 09/06/18:


    Curr Med Res Opin. 2018 Sep 5:1-22.

    A randomized, double-blinded, placebo-controlled, parallel trial of vitamin D3 supplementation in adult patients with migraine.

    BACKGROUND: Vitamin D levels have been linked to certain pain states, including migraine. We investigated whether vitamin D supplementation would be beneficial for adult patients with migraine (ClinicalTrials.gov Identifier: NCT01695460).

    METHODS: A randomized, double-blind, placebo-controlled parallel trial was conducted in migraine patients (36 women and 12 men, 18-65 years of age). A 4-week baseline period was conducted before randomization to 24 weeks of treatment. Participants were assigned to receive D3-Vitamin® (n = 24, 18 women and 6 men, 100 μg/day D3-Vitamin®) or placebo (n = 24, 18 women and 6 men). Migraine attacks and related symptoms were assessed by self-reported diaries. The response rate (i.e., experiencing a 50% or greater reduction in migraine frequency from baseline to week 24), change in migraine severity, and number of migraine days were recorded. Changes in migraine-related symptoms, HIT-6TM scores, and pain sensitivity tests (pressure pain threshold and temporal summation) were also evaluated. Serum levels of both 25(OH)D and 1,25(OH)2D were assessed from baseline to week 24.

    RESULTS: The number of headache days changed from 6.14±3.60 in the treatment group and 5.72±4.52 in the placebo group at baseline to 3.28±3.24 and 4.93±3.24 by the end of the trial, respectively. Migraine patients on D3-Vitamin® demonstrated a significant decrease (p < 0.001) in migraine frequency from baseline to week 24 compared with placebo. However, migraine severity, pressure pain thresholds or temporal summation did not show a significant change. 25(OH)D levels increased significantly for the D3-Vitamin® group during the first 12 weeks of treatment. There was no significant change in 1,25(OH)2D. No side effects were reported or noted. CONCLUSIONS: D3-Vitamin® was superior to placebo in reducing migraine days in migraine patients. Larger studies are required to confirm that vitamin D3 might be one of the prophylactic options for adult patients with migraine. Be well! JP

  24. JP Says:

    Updated 09/15/18:


    Cephalalgia. 2018 Sep 13:333102418801584.

    A prospective pilot study of the effect on catecholamines of mindfulness training vs pharmacological prophylaxis in patients with chronic migraine and medication overuse headache.

    Aim: To address whether, in patients with chronic migraine and medication overuse headache, mindfulness-based treatment is associated with changes in plasma levels of catecholamines and elusive amines that are similar to those observed in patients undergoing pharmacological prophylaxis. Methods: In this non-randomized, clinic-based effectiveness study, patients aged 18-65, with a history of chronic migraine ≥ 10 years and overuse of triptans or non-steroidal anti-inflammatory drugs ≥ 5 years, were enrolled. Upon completion of a structured withdrawal program, patients received either pharmacological prophylaxis or six weekly sessions of mindfulness-based treatment and were followed for 12 months. Daily headache diaries were used to record headache frequency and medication intake; catecholamines (noradrenaline, epinephrine and dopamine) and levels of elusive amines were assayed from poor platelet plasma. Results: Complete follow-up data were available for 15 patients in the pharmacological prophylaxis-group (14 females, average age 44.1) and 14 in the mindfulness treatment-group (all females, average age 46.4), and all variables were comparable between groups at baseline. At 12 months, significant improvement ( p < .001) was found in the pharmacological prophylaxis group for headache frequency and medication intake (by 51% and 48.7%, respectively), noradrenaline, epinephrine and dopamine (by 98.7%, 120.8% and 501.9%, respectively); patients in the mindfulness treatment-group performed similarly. For elusive amines, no longitudinal changes were found. Conclusions: The similar improvement trends observed in the two groups of patients further support the utility of mindfulness-based treatment in migraine care, and reinforce the hypothesis that alteration and normalization of tyrosine metabolism are implicated in migraine chronification and in remission of chronic migraine. Be well! JP

  25. JP Says:

    Updated 01/10/19:


    Cephalalgia. 2019 Jan 8:333102418820102.

    The effects of a multispecies probiotic supplement on inflammatory markers and episodic and chronic migraine characteristics: A randomized double-blind controlled trial.

    BACKGROUND: The current study was designed to assess the effect of supplementation with a 14-strain probiotic mixture on episodic and chronic migraine characteristics.

    METHODS: Forty episodic and 39 chronic migraine patients who completed this randomized double-blind controlled trial received two capsules of multispecies probiotic or placebo. The migraine severity was assessed by visual analog scale (VAS). The number of abortive drugs consumed, migraine days, frequency and duration of attacks were recorded on paper-based headache diaries. Serum tumor necrosis factor alpha (TNF-α) and C- reactive protein (CRP) levels were measured at baseline and the end of the intervention.

    RESULTS: After a 10-week intervention, among episodic migraineurs the mean frequency of migraine attacks significantly reduced in the probiotic group compare to the placebo group (mean change: -2.64 vs. 0.06; respectively, p < 0.001). A significant reduction was also evident in the migraine severity (mean decrease: -2.14 in the probiotic group and 0.11 in the placebo group; p < 0.001). Episodic migraineurs who received the probiotic also showed significant reduction in abortive drug usage per week (mean change: -0.72; p < 0.001) compare to baseline, while there was no significant changes within the placebo group. In chronic migraine patients, after an 8-week intervention, the mean frequency of migraine attacks significantly reduced in the probiotic compared to the placebo group (mean change: -9.67 vs. -0.22; p ≤ 0.001). In contrast to the placebo, probiotic supplementation significantly decreased the severity (mean changes: -2.69; p ≤ 0.001), duration (mean changes: -0.59; p ≤ 0.034) of attacks and the number of abortive drugs taken per day (mean changes: -1.02; p < 0.001), in chronic migraine patients. We failed to detect any significant differences in the serum levels of inflammatory markers at the end of the study either in chronic or in episodic migraineurs. DISCUSSION: The results of this study showed that the 14-strain probiotic mixture could be an effective and beneficial supplement to improve migraine headache in both chronic and episodic migraineurs. Further research is required to confirm our observations. Be well! JP

  26. JP Says:

    Updated 01/28/19:


    Cephalalgia. 2019 Jan 6:333102418821661.

    The effects of concurrent Coenzyme Q10, L-carnitine supplementation in migraine prophylaxis: A randomized, placebo-controlled, double-blind trial.

    PURPOSE: The present study aimed to determine the effects of combined supplementation of Coenzyme Q10 with L-carnitine on mitochondrial metabolic disorders marker and migraine symptoms among migraine patients.

    METHODS: A total of 56 men and women, between 20-40 years of age with migraine headache, participated in this randomized, double-blind, placebo-controlled, parallel study. The subjects were randomly assigned to receive either 30 mg/day Coenzyme Q10 and 500 mg/day L-carnitine at the same time and/or placebo tablets for 8 weeks. The measurements were completed at the beginning and end of the study. The primary outcome was severity of headache attacks. The secondary outcomes included duration, frequency of headache attacks, the headache diary results (HDR), and serum levels of lactate.

    RESULTS: A significant reduction was obtained in serum levels of lactate (-2.28 mg/dl, 95% CI: -3.65, -0.90; p = 0.002), severity (-3.03, 95% CI: -3.65, -2.40; p ≤ 0.001), duration (-7.67, 95% CI: -11.47, -3.90; p ≤ 0.001), frequency (-5.42, 95% CI: -7.31, -3.53; p ≤ 0.001) and HDR (-103.03, 95% CI: -145.76, -60.29; p ≤ 0.001) after 8 weeks.

    CONCLUSION: This double-blind parallel study provides evidences supporting the beneficial effects of Coenzyme Q10 and L-carnitine supplements on serum levels of lactate and migraine symptoms.

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