Riboflavin for Migraine Prevention
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
While various medications exist for migraine prevention and relief, many individuals seek natural supplements for treatment. Vitamin B2, also known as riboflavin, is a non-pharmacological option that has gained attention in recent years. In today’s blog post, we will dive deeper into the research behind vitamin B2 for migraine prevention and explore its efficacy and potential benefits.
Riboflavin is a water-soluble vitamin member of the vitamin B complex group [1]. Milk and dairy products contain high quantities of riboflavin and vitamin D. Fatty fish (i.e., salmon, and tuna) are another source of riboflavin, and certain fruits and vegetables [1]. Riboflavin is involved in the metabolism of macronutrients and the production of some B-complex vitamins [1]. Further, riboflavin plays an active role in redox reactions in metabolic pathways [2]. These redox reactions are critical for neutralizing free radicals and reducing oxidative stress [3]. When the body is deficient in riboflavin, it can lead to decreased antioxidant capacity and increased susceptibility to oxidative stress. When there is oxidative stress in the body, the imbalance between antioxidants and free radicals can lead to inflammation and damage to cells, especially those in the brain [4]. In migraine, oxidative stress may contribute to the activation of pain pathways and the release of certain chemicals that trigger inflammation. Thus, this process can trigger migraine attacks or intensify symptoms.
A randomized trial investigating the combination of riboflavin, magnesium, and feverfew for migraine prevention provided a daily dose of riboflavin 400 mg, magnesium 300 mg, and feverfew 100 mg to 49 patients over three months [5]. The researchers found that riboflavin 25 mg showed an effect comparable to a combination of riboflavin 400 mg, magnesium 300 mg, and fever 100 mg [5]. In an open-label study performed in a specialized outpatient clinic investigating the efficacy of riboflavin for the prevention of migraine, patients received 400 mg of riboflavin each day [6]. The patients were followed from baseline to 6 months after treatment, and headache frequency, duration, intensity, and use of integrative medications were recorded. Headache frequency was reduced from 4 days/month at baseline to 2 days/month after the 3 and 6-month mark [6]. In a systematic review of the use of riboflavin for migraine prevention, it was reported that a total of 11 clinical trials had a mixed effect of riboflavin [2]. Five clinical trials found a consistent positive therapeutic effect in adults [2].
Riboflavin is available as single-ingredient oral tablets of 25 mg, 50 mg, and 100 mg, in addition to oral capsules of 400 mg [5]. Riboflavin is also available in conjugation with other water-soluble multivitamins [1]. The recommended dosage for riboflavin for migraine prophylaxis is 400 mg daily. Riboflavin is relatively safe to administer as it has limited water solubility; however, it is important to use caution if pregnant.Riboflavin may cause benign urine discoloration [1]. In terms of drug-drug interactions, tricyclic antidepressants can interfere with riboflavin.
In conclusion, riboflavin shows promise as a migraine preventive treatment supported by scientific research. More studies are needed to highlight the precise mechanisms of action and optimal dosage. Riboflavin has a safe side effect profile and is a potentially beneficial option for individuals seeking natural migraine treatments. As always, it is important to consult with a healthcare professional before starting any new supplement regimen.
References:
- Peechakara BV, Sina RE, Gupta M (2024) Vitamin B2 (Riboflavin). In: StatPearls. StatPearls Publishing, Treasure Island (FL)
- Thompson DF, Saluja HS (2017) Prophylaxis of migraine headaches with riboflavin: A systematic review. J Clin Pharm Ther 42:394–403. https://doi.org/10.1111/jcpt.12548
- Suwannasom N, Kao I, Pruß A, et al (2020) Riboflavin: The Health Benefits of a Forgotten Natural Vitamin. Int J Mol Sci 21:950. https://doi.org/10.3390/ijms21030950
- Borkum JM (2016) Migraine Triggers and Oxidative Stress: A Narrative Review and Synthesis. Headache 56:12–35. https://doi.org/10.1111/head.12725
- Maizels M, Blumenfeld A, Burchette R (2004) A Combination of Riboflavin, Magnesium, and Feverfew for Migraine Prophylaxis: A Randomized Trial. Headache 44:885–890. https://doi.org/10.1111/j.1526-4610.2004.04170.x
- Boehnke C, Reuter U, Flach U, et al (2004) High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre. Eur J Neurol 11:475–477. https://doi.org/10.1111/j.1468-1331.2004.00813.x