Treating Migraine: Which Natural Substances Actually Help
For most people, migraine is a long-term problem. Many affected individuals therefore look for plant-based and micronutrient-supported strategies to reduce the frequency and intensity of their attacks without having to rely on painkillers. An overview of the mechanisms underlying migraine disorders can be found in our previous article. The good news now is: the effectiveness of some substances is supported by randomized studies. The less good news: not everything circulating in guidebooks is evidence-based.
This article is therefore not about wishful thinking, but about well-founded knowledge on phytotherapies and more.
From Micronutrients to Plants: Natural Compounds Between Traditional Views and Scientific Verification
P Plant compounds and naturopathic approaches are often used in migraine as a complement to pharmacological therapy. However, not every “natural” substance has scientifically proven efficacy. While some plant compounds, micronutrients, or hormones have been investigated in randomized studies for migraine prophylaxis or acute treatment, much else is primarily based on experiential medicine.
The following overview therefore focuses exclusively on substances for which real studies on migraine exist — including classification of the evidence and typical dosages:
· Vitamin B2 (Riboflavin): Mitochondrial Energy for the Brain
In migraine, an impaired energy supply in the brain is often assumed. As a result, nerve cells more quickly enter an energetic deficit, become “hyperexcitable”, and more susceptible to migraine attacks. Riboflavin is a central cofactor of the mitochondrial respiratory chain (via FMN and FAD) and can improve ATP production. A more stable energy supply to nerve cells can increase the stimulus threshold and thereby reduce the frequency of attacks.
A randomized, placebo-controlled study showed that 400 mg daily over three months can significantly reduce attack frequency (Schoenen et al., 1998).
· Vitamin B Complex (B6, B9, B12): For Vascular Function, Against Homocysteine and Migraine With Aura
These vitamins lower homocysteine levels. Elevated homocysteine has been associated with migraine with aura because it can affect blood vessels, nerve cells, and inflammatory processes. Lower homocysteine, in turn, may stabilize vascular function in the brain and reduce excessive neuronal excitability — both important factors in attacks preceded by aura. In addition, vitamin B6 supports the synthesis of neurotransmitters (e.g., serotonin) involved in pain processing. Folic acid and B12 improve methylation, which is important for nerve function and brain metabolism.
In a randomized study in migraine with aura, daily supplementation with 25 mg vitamin B6, 2 mg folic acid, and 400 µg vitamin B12 led to a significant reduction in attacks and migraine-related impairment (Lea et al., 2009).
· Coenzyme Q10: Mitochondrial Support for Prophylaxis
Coenzyme Q10 supports mitochondrial energy production (ATP) in nerve cells. By improving mitochondrial function, coenzyme Q10 can stabilize energy availability, reduce neuronal hyperexcitability, and thereby lower the frequency of attacks. In addition, its antioxidant properties counteract oxidative stress, which is also involved in migraine development, further supporting a preventive effect.
It has been shown that a daily intake of 300 mg can lead to a significant reduction in migraine frequency compared with placebo (Sándor et al., 2005).
· Ginger: A Plant-Based Option in Acute Migraine Attacks
Ginger (Zingiber officinale) is the ‘Medicinal Plant of the Year 2026’ (awarded in Germany). Its constituents, especially gingerols and shogaols, exhibit anti-inflammatory as well as antioxidant properties and can interact with prostaglandin- and serotonin-mediated signaling pathways involved in the development of attacks. Ginger does not primarily alter neuronal excitability in the long term and is therefore not mainly prophylactic, but rather influences pain processing, inflammatory reactions, and the occurrence of nausea in the acute phase.
In a randomized clinical study, the intake of 250 mg ginger powder during acute migraine led to a significant reduction in pain, comparable to the effect of sumatriptan, with a lower rate of side effects (Maghbooli et al., 2014).
· Magnesium: The Best-Documented Micronutrient in Migraine
An insufficient magnesium supply can increase neuronal hyperexcitability and promote so-called cortical spreading depression, which plays a role particularly in migraine with aura. In addition, magnesium influences NMDA receptors, calcium channels, and neurotransmitter release, thereby exerting a stabilizing effect on neuronal signal transmission. Through these mechanisms, magnesium can have a prophylactic effect, but it does not inhibit acute pain.
A meta-analysis of randomized controlled trials shows that both oral and intravenous magnesium can reduce the frequency and intensity of attacks. Oral dosages in studies were usually in the range of about 400–600 mg elemental magnesium per day (Chiu et al., 2016).
· Melatonin: Sleep as an Underestimated Factor
Since migraine is often associated with sleep disturbances, disrupted circadian rhythms, and increased stimulus sensitivity, stabilizing the circadian system is considered a biologically plausible approach. The sleep hormone melatonin also has antioxidant effects and modulates neurovascular and inflammatory processes that may be involved in migraine development.
Evening intake of 3 mg over several months led to a significant reduction in migraine days, as studies have shown. Melatonin was compared with placebo and amitriptyline, an antidepressant prescribed for migraine relief. Melatonin proved to be effective and associated with fewer side effects than the comparison treatments (Gonçalves et al., 2016).
· Feverfew: The Standardized Phytotherapy for Migraine
Pharmacologically, the compound parthenolide is of particular interest, as it shows inflammation-modulating effects and can intervene in serotonergic and neurovascular processes involved in migraine development.
Not the dried herb itself, but a standardized CO₂ extract (MIG-99) was examined in clinical studies. In a randomized, double-blind, placebo-controlled multicenter study, the intake of 6.25 mg of the standardized extract three times daily led to a significant reduction in migraine frequency compared with placebo (Diener et al., 2005). However, the evidence for feverfew is heterogeneous. While standardized extracts show positive effects in controlled studies, results for non-standardized preparations are inconsistent. Feverfew is therefore considered a complementary phytotherapeutic approach with moderate evidence in migraine prophylaxis
· Omega-3 Fatty Acids: Inflammation Regulation Through Nutrition
The long-chain fatty acids EPA and DHA influence the composition of neuronal cell membranes, signal transmission in the nervous system, and the formation of inflammation-modulating mediators.
A targeted dietary change with increased intake of EPA and DHA and simultaneous reduction of omega-6 fatty acids leads to a significant reduction in migraine frequency (Ramsden et al., 2021). Studies also show that not only the absolute omega-3 intake, but especially the ratio of omega-3 to omega-6 fatty acids may be decisive. Omega-3 fatty acids are therefore a holistic, nutrition-based aspect of migraine prophylaxis.
Conclusion: What Natural Compounds Can Achieve in Migraine
Plant-based compounds, but also certain nutrients or the hormone melatonin, can be a meaningful complement in migrstre, especially in prophylaxis. Selected micronutrients and phytotherapeutic approaches can positively influence the frequency of migraine occurrence and the resilience of the nervous system when used in adequate dosages and over several weeks.
However, correct classification is crucial: effectiveness depends on tested dosages, standardized extracts, and appropriate selection. Realistically, the strength of plant-based compounds in migraine lies primarily in long-term stabilization — for example of sleep rhythm, stimulus processing, stress response, and inflammatory processes.
FAQ – Frequently Asked Questions About Complementary Medicine and Phytotherapies in Migraine
1. How long should plant-based therapy be tried in migraine before forming an opinion on whether it helps?
Most studies ran for about three months. An evaluation is usually only meaningful after several weeks.
2. Are plant compounds automatically safer than medications?
No, plant extracts can also cause side effects or interactions. Standardization is crucial, and the substances listed here are generally low in side effects and interactions.
3. Is it therefore permissible to combine several substances?
Yes, but this should, if necessary, be coordinated medically to avoid overdosing or unwanted effects.
4. Which additional complementary measures can be useful in migraine?
Many non-pharmacological measures play an important role in migraine prophylaxis:
Systematic reviews on acupuncture show that it can reduce the frequency and intensity of attacks, with effects in some studies comparable to classical preventive measures (Linde et al., 2016).
Meditation and yoga also aim at regulating stress, stimulus processing, and the autonomic nervous system. Since stress, sleep disturbances, and overstimulation are among the most common migraine triggers, regular mindfulness exercises, breathing techniques, and yoga can contribute to reducing susceptibility in the long term. Studies indicate that mindfulness-based approaches and yoga-based programs can reduce disease burden when practiced regularly (Wells et al., 2021; Kumar et al., 2020).
In our next article, we will address a disease with a very high number of unreported cases. Further information on migraine and many other topics can be found, in addition to the blog, in the volumes of our “Codex Humanus” and the “Medizinskandale” series. Feel free to visit our online shop.
Sources:
· Schoenen, J. et al. (1998): “Effectiveness of high-dose riboflavin in migraine prophylaxis: a randomized controlled trial,” Neurology.
· Lea, R. A. et al. (2009): “The effects of vitamin supplementation and MTHFR (C677T) genotype on homocysteine-lowering and migraine disability,” Pharmacogenetics and Genomics.
· Sándor, P. S. et al. (2005): “Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial,” Neurology.
· Niedenthal, T. (05.01.2026): “Ingwer (Zingiber officinale ROSCOE) – Arzneipflanze des Jahres 2026,” Arzneipflanzengarten / Institut für Pharmazeutische Biologie und Phytochemie (IPBP), Universität Münster.
· Maghbooli, M. et al. (2014): “Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine,” Phytotherapy Research.
· Chiu, H. Y. et al. (2016): “Effects of Intravenous and Oral Magnesium on Reducing Migraine: A Meta-Analysis of Randomized Controlled Trials,” Pain Physician.
· Gonçalves, A. L. et al. (2016): “Randomised clinical trial comparing melatonin 3 mg, amitriptyline 25 mg and placebo for migraine prevention,” Journal of Neurology, Neurosurgery & Psychiatry.
· Diener, H. C. et al. (2005): “Efficacy and safety of 6.25 mg t.i.d. feverfew CO₂-extract (MIG-99) in migraine prevention: a randomized, double-blind, multicentre, placebo-controlled study,” Cephalalgia.
· Ramsden, C. E. et al. (2021): “Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial,” BMJ.
· Linde, K. et al. (2016): “Acupuncture for the prevention of episodic migraine,” Cochrane Database of Systematic Reviews.
· Wells, R. E.; O’Connell, N.; Pierce, C. R. et al. (2021): “Effectiveness of Mindfulness Meditation vs Headache Education for Adults With Migraine: A Randomized Clinical Trial,” JAMA Internal Medicine.
· Kumar, A. et al. (2020): “Effect of yoga as add-on therapy in migraine (CONTAIN): A randomized clinical trial,” Neurology.