Kill the Pain Without the Drugs

Migraine headaches can be awful—and many people find that the side effects of the prescription medications given to prevent or treat them can be just as bad. For instance, listed among the numerous possible adverse effects for propranolol, a commonly prescribed migraine medication, are vertigo, facial swelling, receding gums, cardiac arrhythmia—and, believe it or not, headache.

However, compelling research has shown that certain natural remedies help prevent, soothe and reduce the frequency of migraine headaches—without the side effects of drugs.

Important: Check with your doctor to make sure that none of these natural treatments will interact with any other medications that you take or conditions that you have. Then I suggest working through the list to see what helps you. You also can combine remedies, such as riboflavin, magnesium and CoQ10, but always check with your doctor.


Also called vitamin B-2, riboflavin occurs naturally in certain foods. It helps convert food into energy…it’s an antioxidant that fights free-radical damage…and it helps activate other forms of vitamin B.

How riboflavin helps migraines: It’s thought that some migraines occur because oxygen is not being properly metabolized in the mitochondria (the so-called “power plants” of cells), so riboflavin’s energy-boosting function may help prevent this type of migraine.

The research: The first published study evaluating riboflavin for migraine therapy reported that taking 5 milligrams (mg) three times daily over several months diminished migraine frequency—some subjects said that taking hourly doses halted acute migraines. Studies done in 1994 and 1998 found that taking 400 mg/day of riboflavin helped reduce frequency and severity of migraines, with the best results seen in the third month of therapy. A 2004 study of migraine patients who had not responded to other therapies yielded a 50% reduction in migraine frequency for patients who took riboflavin daily.

How to take riboflavin: I suggest 400 mg daily. It’s safe to take riboflavin indefinitely. Some people notice improvement quickly, but others see benefits only after three or four months of taking riboflavin daily. A small percentage of people find that riboflavin makes their faces flush and/or report digestive upset—if that happens to you, you might try dividing your dose in half (200 mg, morning and night) or just take 200 mg/day.


Also called ubiquinone, CoQ10 is a substance that occurs naturally in the body that helps with mitochondrial function and energy production. It’s also an antioxidant that may help stem inflammation.

How CoQ10 helps migraines: CoQ10 works similarly to riboflavin, supporting cellular energy production. Its antioxidant power is so strong that it’s often recommended for people with certain types of heart disease and muscular and nervous system problems.

The research: Several small studies found that taking CoQ10 reduced migraine frequency. In a 2002 study of 32 adults taking 150 mg/day, 61% said that the days they experienced migraines were down by 50% or more. A 2005 study found that 48% of participants experienced a 50% or greater decrease in frequency, and a 2007 study of children and adolescents had similar results.

How to take CoQ10: I typically advise patients to start with a dose of 150 mg/day and, if needed, work their way up to taking three daily doses of 100 mg (morning, noon and night). One percent of people report some stomach upset with CoQ10—if you’re in that group, stop taking CoQ10.


The vast majority of Americans are deficient in magnesium, which is a problem because it is essential to the healthy function of muscles and the nervous system. I believe magnesium is very helpful for people with a deficiency—not so much for those whose magnesium levels already are healthy.

How magnesium helps migraines: Magnesium plays a role in many cellular processes and also is responsible for smooth-muscle activity in the nerves and arteries—both factors in migraines. Also, magnesium deficiency has been shown to cause spasms of the cerebral arteries, associated with migraine.

The research: A 1995 study reported that intravenous delivery of 1,000 mg of magnesium was effective at halting migraines. Studies examining the use of oral magnesium (600 mg/day) to prevent migraines were done in 1996 and 2008 and found that it reduced both the frequency and severity of the headaches.

How to take magnesium: A good dose to begin with is 100 mg twice daily. Gradually work your way up to 400 mg/day.


5-Hydroxytryptophan (5-HTP) is a building block used by the body to produce serotonin, a neurotransmitter that aids cellular communication and also is associated with mood. Available in many foods, 5-HTP is produced from the amino acid tryptophan.

How 5-HTP helps migraines: 5-HTP gets converted by the body to serotonin (found in the nervous system and the gut), which is involved in the conduction of pain signals and the dilation/constriction of blood vessels—both relevant to migraine pain.

The research: A 1973 study compared the efficacy of 5-HTP therapy (200 mg/day) and a prescription medication in 20 patients and found identical results—both treatments achieved a 55% reduction in frequency, and the 5-HTP patients who continued taking the supplement reported continual improvement. Subsequent studies found 5-HTP effective at soothing the pain of migraines already in progress.

How to take 5-HTP: Begin with a small dose (50 mg to 100 mg), and if need be, work your way up to the maximum daily dosage (300 mg to 400 mg), taken at bedtime. Side effects are mild and may include gastrointestinal problems and weird dreams.


This sleep-promoting hormone has numerous positive effects, including suppression of the substances that promote pain. It also fosters anti-inflammatory activity, regulation of serotonin and nerve and blood vessel interaction.

How melatonin helps migraines: A theory about one possible cause of migraine relates to an imbalance in the relationship between the hypothalamus and the pineal gland that affects adequate melatonin production.

The research: A 2004 study followed 34 adult patients who were given a nightly melatonin dose of 3 mg for three months—25% stopped getting migraines altogether and 80% reported a 50% or greater reduction in frequency. A 2008 study examining children and adolescents taking 3 mg of melatonin at bedtime found a 50% or greater reduction in frequency for 71% of participants.

How to take melatonin: Start with a dose of 0.5 mg or 1 mg and go up to 2, 3 or 5 mg, depending on your reaction. Take melatonin in the evening, preventively, or as treatment for an acute migraine. Melatonin yields superior results and has far fewer side effects than common migraine drugs.


Many of us take vitamin D, but one-third of American adults still don’t get enough. That’s bad news because it affects blood pressure and immune function. Also, low levels are linked to a range of chronic diseases including diabetes, osteoporosis, fibromyalgia and numerous types of cancer.

How vitamin D helps migraines: Though research shows the benefits of vitamin D for migraines, the actual mechanisms by which vitamin D helps prevent or treat migraines aren’t well-understood. Since we do know that deficiencies affect all ­organ systems, it makes sense that raising levels of vitamin D would be beneficial.

The research: Studies done in 2009 and 2010 found correlations between vitamin D deficiency and chronic tension and migraine headaches—and noted improvement with vitamin D therapy.

How to take vitamin D: It’s a good idea to get your vitamin D levels tested and discuss the proper dosage with your doctor based on the results. Mainstream doctors typically recommend between 200 international units (IU) and 800 IU a day. Some alternative practitioners go far higher, to 5,000 IU/day, or even more.