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B vitamins and their combination could reduce migraine headaches: A randomized double-blind controlled trial

Document Type : Original Article

Authors

1 Department of Clinical Nutrition and Dietetics, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

3 Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Headache Department, Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

4 Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

5 Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

6 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: The B vitamins can potentially help prevent migraine. This study was designed to examine the effects of supplementation with thiamine (B1), pyridoxine (B6), cobalamin (B12), folic acid (B9), and a combination of these vitamins on women with episodic migraine (EM).
Methods: This study was a double-blind, placebo-controlled, randomized, clinical trial conducted on 120 women with EM. The participants were divided into the 6 groups of B1 (n = 20), B6 (n = 20), B12 (n = 20), B9 (n = 20), vitamin B complex (n = 20), and placebo (n = 20). Subjects received 1 capsule daily for 12 weeks. As part of the baseline and post-intervention phases, paper-based headache diaries were used to record the number of abortive drugs consumed and the frequency of headache attacks, and the Migraine Disability Assessment Questionnaire (MIDAS) was used to assess migraine disability.
Results: A 16-week study on women with EM revealed that the mean changes in the frequency of headache attacks decreased significantly in all vitamin groups in comparison with the placebo group (P < 0.001). In contrast to the placebo, there was also a significant improvement in the migraine disability score in each vitamin group (P < 0.001). The 12-week supplementation with vitamins B9, B1, B6, B12, and B complex also brought on a significant decrease in the use of abortive drugs compared to the placebo group (P = 0.032).
Conclusion: The results of this study showed that B1, B6, B12, and B9, and a combination of these vitamins could be effective as an adjuvant in treatment and prophylaxis of EM. Further large trials with long-term follow-ups will be required to confirm our results.

Keywords

References
  1. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18(5): 459-80.
  2. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38(1): 1-211.
  3. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1545-602.
  4. Farhadi Z, Alidoost S, Behzadifar M, Mohammadibakhsh R, Khodadadi N, Sepehrian R, et al. The prevalence of migraine in Iran: A systematic review and meta-analysis. Iran Red Crescent Med J 2016; 18(10): e40061.
  5. Gazerani P, Cairns BE. Sex-specific pharmacotherapy for migraine: A narrative review. Front Neurosci 2020; 14: 222.
  6. Kursun O, Yemisci M, van den Maagdenberg AMJM, Karatas H. Migraine and neuroinflammation: The inflammasome perspective. J Headache Pain 2021; 22(1): 55.
  7. Jawed S, Ali W, Yaqoob U, Shah S, Uddin SMM, Haq A. Effect of migraine headache on productivity of patients according to migraine disability assessment score: A cross-sectional study. Pain Ther 2019; 8(2): 233-8.
  8. Khan J, Asoom LIA, Sunni AA, Rafique N, Latif R, Saif SA, et al. Genetics, pathophysiology, diagnosis, treatment, management, and prevention of migraine. Biomed Pharmacother 2021; 139: 111557.
  9. Ji Y, Rizk A, Voulalas P, Aljohani H, Akerman S, Dussor G, et al. Sex differences in the expression of calcitonin gene-related peptide receptor components in the spinal trigeminal nucleus. Neurobiol Pain 2019; 6: 100031.
  10. Ghorbani Z, Togha M, Rafiee P, Ahmadi ZS, Rasekh MR, Djalali M, et al. Vitamin D3 might improve headache characteristics and protect against inflammation in migraine: A randomized clinical trial. Neurol Sci 2020; 41(5): 1183-92.
  11. Liampas I, Siokas V, Mentis AA, Aloizou AM, Dastamani M, Tsouris Z, et al. Serum homocysteine, pyridoxine, folate, and vitamin B12 levels in migraine: Systematic review and meta-analysis. Headache 2020; 60(8): 1508-34.
  12. Aydin H, Bucak IH, Geyik M. Vitamin B12 and folic acid levels in pediatric migraine patients. Acta Neurol Belg 2021; 121(6): 1741-4.
  13. Liampas IN, Siokas V, Aloizou AM, Tsouris Z, Dastamani M, Aslanidou P, et al. Pyridoxine, folate and cobalamin for migraine: A systematic review. Acta Neurol Scand 2020; 142(2): 108-20.
  14. Buse DC, Armand CE, Charleston L, Reed ML, Fanning KM, Adams AM, et al. Barriers to care in episodic and chronic migraine: Results from the Chronic Migraine Epidemiology and Outcomes Study. Headache 2021; 61(4): 628-41.
  15. Antonaci F, Ghiotto N, Wu S, Pucci E, Costa A. Recent advances in migraine therapy. Springerplus 2016; 5: 637.
  16. Nattagh-Eshtivani E, Sani MA, Dahri M, Ghalichi F, Ghavami A, Arjang P, et al. The role of nutrients in the pathogenesis and treatment of migraine headaches: Review. Biomed Pharmacother 2018; 102: 317-25.
  17. Reyes-Garcia G, Caram-Salas NL, Medina-Santillan R, Granados-Soto V. Oral administration of B vitamins increases the antiallodynic effect of gabapentin in the rat. Proc West Pharmacol Soc 2004; 47: 76-9.
  18. Lea R, Colson N, Quinlan S, Macmillan J, Griffiths L. The effects of vitamin supplementation and MTHFR (C677T) genotype on homocysteine-lowering and migraine disability. Pharmacogenet Genomics 2009; 19(6): 422-8.
  19. Togha M, Rahmanzadeh R, Nematgorgani S, Yari Z, Razeghi Jahromi S, et al. Suppression of menstrual-related migraine attack severity using pyridoxine, thiamine, and cyanocobalamin: A quasi-experimental within-subject design. Arch Neurosci 2020; 7(3): e93103.
  20. Menon S, Lea RA, Roy B, Hanna M, Wee S, Haupt LM, et al. Genotypes of the MTHFR C677T and MTRR A66G genes act independently to reduce migraine disability in response to vitamin supplementation. Pharmacogenet Genomics 2012; 22(10): 741-9.
  21. Faraji H, Paknahad Z, Chitsaz A. dietary intake of thiamine in migraine patients and healthy subjects: A case-control study. Clin Nutr Res 2018; 7(1): 40-7.
  22. Antonio C, Massimo T, Gianpaolo Z, Immacolata PM, Erika T. Oral high-dose thiamine improves the symptoms of chronic cluster headache. Case Rep Neurol Med 2018; 2018: 3901619.
  23. Mohammady M, Janani L. Randomization in randomized clinical trials: From theory to practice. Hayat 2016; 22(2): 102-14.
  24. Razeghi JS, Abolhasani M, Ghorbani Z, Sadre-Jahani S, Alizadeh Z, Talebpour M, et al. Bariatric surgery promising in migraine control: A controlled trial on weight loss and its effect on migraine headache. Obes Surg 2018; 28(1): 87-96.
  25. Zandifar A, Asgari F, Haghdoost F, Masjedi SS, Manouchehri N, Banihashemi M, et al. Reliability and validity of the migraine disability assessment scale among migraine and tension type headache in Iranian patients. Biomed Res Int 2014; 2014: 978064.
  26. Askari G, Nasiri M, Mozaffari-Khosravi H, Rezaie M, Bagheri-Bidakhavidi M, Sadeghi O. The effects of folic acid and pyridoxine supplementation on characteristics of migraine attacks in migraine patients with aura: A double-blind, randomized placebo-controlled, clinical trial. Nutrition 2017; 38: 74-9.
  27. Prakash S, Kumar SA, Rathore C. Chronic migraine responding to intravenous thiamine: a report of two cases. Headache 2016; 56(7): 1204-9.
  28. Mauro GL, Martorana U, Cataldo P, Brancato G, Letizia G. Vitamin B12 in low back pain: A randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci 2000; 4(3): 53-8.
  29. Fu QG, Carstens E, Stelzer B, Zimmermann M. B vitamins suppress spinal dorsal horn nociceptive neurons in the cat. Neurosci Lett 1988; 95(1-3): 192-7.
  30. Franca DS, Souza AL, Almeida KR, Dolabella SS, Martinelli C, Coelho MM. B vitamins induce an antinociceptive effect in the acetic acid and formaldehyde models of nociception in mice. Eur J Pharmacol 2001; 421(3): 157-64.
  31. Liu D, Ke Z, Luo J. Thiamine deficiency and neurodegeneration: the interplay among oxidative stress, endoplasmic reticulum stress, and autophagy. Mol Neurobiol 2017; 54(7): 5440-8.
  32. Artero-Morales M, Gonzalez-Rodriguez S, Ferrer-Montiel A. TRP channels as potential targets for sex-related differences in migraine pain. Front Mol Biosci 2018; 5: 73.
  33. Bianchi A, Salomone S, Caraci F, Pizza V, Bernardini R, D'Amato CC. Role of magnesium, coenzyme Q10, riboflavin, and vitamin B12 in migraine prophylaxis. Vitam Horm 2004; 69: 297-312.
  34. van der Kuy PH, Merkus FW, Lohman JJ, ter Berg JW, Hooymans PM. Hydroxocobalamin, a nitric oxide scavenger, in the prophylaxis of migraine: An open, pilot study. Cephalalgia 2002; 22(7): 513-9.
  35. Togha M, Razeghi JS, Ghorbani Z, Ghaemi A, Rafiee P. An investigation of oxidant/antioxidant balance in patients with migraine: A case-control study. BMC Neurol 2019; 19(1): 323.
  36. Taheri P, Mohammadi F, Nazeri M, Zarei MR, Chamani G, Esfahlani MA, et al. Nitric oxide role in anxiety-like behavior, memory and cognitive impairments in animal model of chronic migraine. Heliyon 2020; 6(12): e05654.
  37. Rajanayagam MA, Li CG, Rand MJ. Differential effects of hydroxocobalamin on NO-mediated relaxations in rat aorta and anococcygeus muscle. Br J Pharmacol 1993; 108(1): 3-5.
  38. Di Rosa G, Attina S, Spano M, Ingegneri G, Sgro DL, Pustorino G, et al. Efficacy of folic acid in children with migraine, hyperhomocysteinemia and MTHFR polymorphisms. Headache 2007; 47(9): 1342-4.
  39. Bager P, Hvas CL, Rud CL, Dahlerup JF. Randomised clinical trial: High-dose oral thiamine versus placebo for chronic fatigue in patients with quiescent inflammatory bowel disease. Aliment Pharmacol Ther 2021; 53(1): 79-86.
  40. Wadekar A, Hepat S, Giri A, Acharya S. Wernicke's encephalopathy with normal neuroimaging -suspect and treat -a case report. J Evol Med Dent Sci 2021; 10: 2021.
  41. Sadeghi O, Nasiri M, Maghsoudi Z, Pahlavani N, Rezaie M, Askari G. Effects of pyridoxine supplementation on severity, frequency and duration of migraine attacks in migraine patients with aura: A double-blind randomized clinical trial study in Iran. Iran J Neurol 2015; 14(2): 74-80.
  42. Menon S, Nasir B, Avgan N, Ghassabian S, Oliver C, Lea R, et al. The effect of 1 mg folic acid supplementation on clinical outcomes in female migraine with aura patients. J Headache Pain 2016; 17(1): 60.
  43. Nematgorgani S, Gholi Z, Razeghi Jahromi S, Togha M, Karimzadeh F. The effect of vitamins b on improving the symptoms of migraine: An overview. Neurosci J Shefaye Khatam 2020; 8(2): 119-29. [In Persian].
  44. Dumanlidag S, Milanlioglu A. Comparison of static and dynamic balance measurements among chronic and episodic migraine patients. Arq Neuropsiquiatr 2021; 79(5): 399-406.
Current Journal of Neurology
Volume 21, Issue 2
April 2022
Pages 105-118
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