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Will Riboflavin help with Migraines?

Studies show a deficit of mitochondrial energy metabolism may play a role in migraine pathogenesis.

Riboflavin, or vitamin B2, is a water-soluble vitamin, which means it is not stored in the body. Therefore, it needs to be replenished in the body every day. Riboflavin is important for body growth and red blood cell production. It is also required for energy metabolism, such as the metabolism of carbohydrates.

Studies show a deficit of mitochondrial energy metabolism may play a role in migraine pathogenesis. Because riboflavin is the precursor of the two flavocoenzymes (FAD and FMN) required by mitochondria, supplemental riboflavin has been investigated as a treatment and/or prevention for migraine.

For example, a randomized trial of 3 months duration compared riboflavin (400 mg) and placebo in 55 patients with migraine. Riboflavin was superior to placebo in reducing attack frequency and headache days. Regarding the latter, the proportion of patients who improved by at least 50%, i.e. “responders,” was 15% for placebo and 59% for riboflavin. Because of its high efficacy, excellent tolerability, and low cost, riboflavin is a promising option for migraine prophylaxis.

Another study investigated patients who received 400 mg riboflavin capsules per day. Headache frequency was significantly reduced from 4 days/month at baseline to 2 days/month after 3 and 6 months. Additionally, the number of abortive anti-migraine tablets (ie. Triptans, ergotamines) was reduced following riboflavin treatment. These results confirmed the findings of previous studies in which riboflavin was demonstrated to be a safe and well-tolerated alternative in migraine prevention and treatment.

By Sandy Cho, MD

  • Boehnke C, Reuter U, Flach U, Schuh-Hofer S, Einhäupl KM, Arnold G. High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre. Eur J Neurol. 2004 Jul;11(7):475-7.
  • Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology. 1998 Feb;50(2):466-70.