Several dietary supplements have been studied for headaches, particularly for migraine prevention. In 2012, the American Academy of Neurology and the American Headache Society issued evidence-based guidelines that classified certain dietary supplements as “effective,” “probably effective,” or “possibly effective” in preventing migraines.
The guidelines concluded that butterbur is effective and should be offered to patients with migraine to reduce the frequency and severity of migraine attacks. The most common side effects of butterbur are belching and other mild digestive tract symptoms. Raw butterbur extracts contain pyrrolizidine alkaloids, which can cause liver damage and cancer. Extracts of butterbur that are almost completely free from these alkaloids are available. It is uncertain whether butterbur products, including reduced-alkaloid products, are safe for prolonged use.
Coenzyme Q10 is an antioxidant that cells need to function properly. It’s available as a dietary supplement and has been studied for a variety of purposes. The guidelines say that coenzyme Q10 is possibly effective and may be considered for migraine prevention. No serious side effects of coenzyme Q10 have been reported. It may interact with some medications, including the anticoagulant (blood-thinning) medication warfarin (Coumadin).
The guidelines say that a specific feverfew extract called MIG-99 is probably effective and should be considered for migraine prevention.Side effects of feverfew may include joint aches, digestive disturbances, and mouth ulcers. It may interact with anticoagulants (blood thinners) and some other medications. Feverfew is not safe for use during pregnancy. Its long-term safety has not been established.
Magnesium deficiency is related to factors that promote headaches. The guidelines say that magnesium is probably effective and should be considered for migraine prevention. Magnesium supplements can cause diarrhea and may interact with some medications. Because the amounts of magnesium people take for migraines are greater than the Tolerable Upper Intake Level for this mineral (the largest amount that’s likely to be safe for almost everyone), magnesium supplements for migraine should be used only under the supervision of a health care provider.
The American Academy of Neurology and American Headache Society’s guidelines say that riboflavin is probably effective and should be considered for migraine prevention. Riboflavin has minimal side effects, but it can cause an intense yellow discoloration of the urine.