If you’ve ever had a migraine, you know it’s not just a bad headache. The throbbing pain, light sensitivity, nausea, and sometimes visual disturbances can completely derail your day. I’ve spent considerable time reviewing the research on complementary therapies for migraine, and while none of these approaches replace proper medical treatment, several show genuine promise as add-on strategies.

What exactly is migraine?

Migraine is a neurological condition that affects roughly 12% of the population, with women experiencing it about three times more often than men. The NHS describes it as a moderate to severe headache felt as a throbbing pain on one side of the head, often accompanied by nausea, vomiting, and increased sensitivity to light or sound. Note 1

What distinguishes migraine from ordinary headaches is the underlying neurovascular dysfunction. The current understanding is that migraine involves abnormal brain activity affecting nerve signals, chemicals, and blood vessels. About 25% of migraine sufferers experience an aura before the headache starts. This might include visual disturbances like flashing lights or blind spots, tingling sensations, or difficulty speaking.

The genetic component is substantial. If one of your parents has migraine, you have roughly a 50% chance of developing it yourself. If both parents are affected, that probability jumps to around 75%. This runs in families more consistently than many people realise.

Common migraine triggers

Research suggests that dietary factors can trigger migraines through several mechanisms, including inflammation, nitric oxide release, and vasodilation. Note 2 Most of what we know about food triggers comes from patient self-reports rather than controlled studies, so there’s individual variation here.

Foods commonly reported as triggers include:

Aged cheeses and fermented dairy products
Certain fruits (ripe bananas, citrus, avocado, raspberries)
Pickled and fermented foods
Alcohol, particularly red wine, beer, and champagne
Processed meats containing nitrates or nitrites
Foods containing MSG
Chocolate
Caffeinated beverages (both consumption and withdrawal)

Beyond diet, other triggers are well documented: Note 3

Hormonal changes: Up to 75% of women with migraine report attacks around menstruation
Stress: Both during stressful periods and during the “let-down” after stress resolves
Sleep disruption: Either too little or too much sleep
Weather changes: Temperature, barometric pressure, and seasonal shifts
Sensory stimuli: Bright lights, loud sounds, strong smells
Physical factors: Muscle tension in the neck and shoulders, dehydration, skipped meals

Keeping a headache diary to identify your personal triggers is actually one of the more practical pieces of advice doctors give. What sets off one person’s migraines may have no effect on another.

6 complementary therapies worth considering

I should be clear from the start: none of these approaches should replace conventional migraine treatment. They’re best thought of as adjunctive therapies that might reduce attack frequency or severity when used alongside standard care. The evidence quality varies considerably.

1. Vitamin D

Vitamin D deficiency affects an estimated 30% to 80% of adults worldwide, depending on how you define deficiency and where people live. The connection to migraine has been investigated in several studies, and the results are moderately encouraging.

A meta-analysis of 6 randomised controlled trials involving 301 migraine patients found that vitamin D supplementation significantly reduced the number of headache attacks per month, the total number of headache days, and scores on the Migraine Disability Assessment Questionnaire. Note 4

What it didn’t change was attack duration or severity. So vitamin D might help prevent migraines from happening, but if you do get one, it probably won’t be shorter or less intense because of supplementation.

My assessment: The evidence is promising but the studies are small. If you’re vitamin D deficient anyway, which many people are, there’s good reason to correct that deficiency. Whether vitamin D helps migraines specifically in people who already have adequate levels is less clear. The NHS recommends adults consider taking a 10 microgram (400 IU) supplement during autumn and winter at minimum.

2. Magnesium

Magnesium participates in over 300 biochemical reactions in the body, including those involved in nerve transmission and muscle function. Migraine sufferers often have lower magnesium levels than people without migraine, though whether this is cause or effect isn’t entirely settled.

The clinical evidence is reasonably strong here. A meta-analysis pooling 21 randomised controlled trials with 1,737 migraine patients found that intravenous magnesium significantly relieved acute migraine within 15 to 45 minutes, and that oral magnesium reduced both migraine frequency and intensity over time. Note 5

The American Headache Society and the American Academy of Neurology have both recognised magnesium as “probably effective” for migraine prevention, which is about as strong an endorsement as complementary therapies typically receive.

My take: This is one of the better-supported options. The main drawback is that higher doses of oral magnesium can cause digestive upset, particularly diarrhoea. Magnesium oxide is the most commonly studied form, usually at doses of 400-600mg daily, but magnesium citrate and glycinate may be better tolerated. The NHS notes that most people should be able to get enough magnesium from diet alone, but supplementation appears safe for most adults at these doses.

3. Riboflavin (Vitamin B2)

Riboflavin is part of the B vitamin complex and serves as a component of two coenzymes involved in energy production and antioxidant protection. The theory is that impaired mitochondrial energy metabolism may play a role in migraine, and riboflavin could help address that.

A meta-analysis of 8 randomised controlled trials and 1 controlled trial involving 673 migraine patients found that vitamin B2 supplementation at 400mg daily for 3 months significantly reduced migraine days, duration, frequency, and pain scores. Note 6

This is a much higher dose than the recommended daily allowance, which is just 1.1-1.3mg for adults. At 400mg, some people notice their urine turns bright yellow, which is harmless but can be surprising if you’re not expecting it.

What I’d note: The evidence for riboflavin is actually quite consistent across studies. It’s also cheap, widely available, and has an excellent safety profile. The downside is that you need to take it for at least 2-3 months before seeing benefits. This isn’t something that works immediately.

4. Melatonin

Melatonin is primarily known as a sleep hormone, but it has broader effects including anti-inflammatory and antioxidant properties. Given that sleep disturbance is both a trigger and a consequence of migraine, there’s biological plausibility to the idea that melatonin might help.

A large meta-analysis of 25 randomised controlled trials with 4,499 migraine patients found that oral melatonin improved migraine frequency. Note 7 When the researchers looked at all outcomes together, including response rates and adverse events, 3mg of immediate-release melatonin at bedtime emerged as the most favourable option.

The mechanisms may involve melatonin’s effects on nitric oxide synthesis, dopamine release, and calcitonin gene-related peptide (CGRP), which is a key player in migraine pathophysiology that newer migraine medications specifically target.

My view: Melatonin has a good safety profile and might be particularly worth trying if your migraines are connected to sleep problems. The effect size isn’t enormous, but it’s a low-risk option. In the UK, melatonin requires a prescription, unlike in some other countries where it’s sold over the counter.

5. Exercise

This one might seem counterintuitive. Many migraine sufferers find that physical exertion triggers attacks. But the evidence suggests that regular, consistent exercise actually reduces migraine frequency over time, even if individual exercise sessions occasionally provoke headaches in the short term.

A meta-analysis of 21 clinical trials with 1,195 migraine patients found that all exercise interventions reduced migraine frequency compared to placebo. Interestingly, strength and resistance training showed the largest effects, followed by high-intensity and moderate-intensity aerobic exercise. Note 8

Why strength training worked best isn’t entirely clear, but one hypothesis relates to the high co-occurrence of neck pain and migraine. Note 9 Strengthening the muscles of the shoulders, neck, and upper back might address postural issues that contribute to headache disorders.

Practical advice: Start gradually if you’re not currently exercising, as sudden intense exercise is more likely to trigger migraines than progressive training. The NHS recommends 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week, plus muscle-strengthening activities on at least 2 days. This general guidance aligns well with what the migraine research suggests.

6. Coenzyme Q10

Coenzyme Q10 (CoQ10) is involved in mitochondrial energy production. Since migraines may involve impaired brain energy metabolism, the rationale for trying CoQ10 is similar to that for riboflavin.

A meta-analysis of 5 studies with 346 migraine patients found that oral CoQ10 at doses of 100-400mg daily for 3 months reduced the number of headache days per month and the duration of monthly attacks compared to placebo. Note 10

What CoQ10 didn’t significantly change was attack severity or the number of attacks per month. So like vitamin D, it may reduce the overall burden of migraine without necessarily making individual attacks less severe.

Where I stand: The evidence is positive but based on fairly small studies. CoQ10 is generally safe but can be expensive depending on the formulation and dose. If you’re already taking it for other reasons, such as alongside a statin medication, the migraine benefit would be a bonus. As a standalone migraine intervention, I’d rank it below magnesium and riboflavin in terms of evidence strength.

Putting this into practice

If you’re considering complementary therapies for migraine, here are some practical points:

Talk to your GP first. This is especially important if you’re on other medications, as some supplements can interact with prescription drugs. Magnesium, for example, can affect the absorption of certain antibiotics.

Give supplements adequate time. Most of these interventions need 2-3 months before you can fairly assess whether they’re working. Quick fixes they are not.

Keep a headache diary. Track your migraine frequency, duration, and severity before and after starting any new approach. Without data, it’s hard to know whether something is actually helping or whether you’re just having a naturally better or worse period.

Don’t abandon proven treatments. These complementary approaches work best alongside standard care, not instead of it. Preventive medications, acute treatments, and lifestyle modifications all have their place.

Consider starting with the better-evidenced options. If I were ranking these six approaches by strength of evidence, I’d put magnesium and riboflavin at the top, exercise and melatonin in the middle, and vitamin D and CoQ10 at the bottom. That’s not to say the latter two don’t work, just that the evidence is less robust.

The bottom line

Migraine is a chronic condition that significantly affects quality of life. While none of these complementary therapies represents a cure, the research suggests that several can meaningfully reduce attack frequency or severity for some people. The safety profiles are generally good, and most are inexpensive.

My honest assessment is that magnesium and riboflavin have the strongest evidence, exercise has the broadest health benefits beyond migraine, and melatonin is worth considering if sleep disruption is part of your migraine pattern. Vitamin D and CoQ10 are reasonable options but supported by smaller studies.

As with most things in medicine, individual responses vary. What works brilliantly for one person may do nothing for another. The practical approach is to try options systematically, track results carefully, and work with your healthcare provider to find the combination that works for you.

References

NHS. Migraine - Overview. https://www.nhs.uk/conditions/migraine/
Finocchi C, Sivori G. Food as trigger and aggravating factor of migraine. Neurol Sci. 2012;33 Suppl 1:S77-80. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857910/
Martin PR. Behavioral management of migraine headache triggers: learning to cope with triggers. Curr Pain Headache Rep. 2010;14(3):221-7. https://pubmed.ncbi.nlm.nih.gov/23996724/
Ghorbani Z, et al. The effect of vitamin D supplementation on migraine: a systematic review and meta-analysis of randomized controlled trials. Headache. 2022;62(2):169-181. https://pubmed.ncbi.nlm.nih.gov/34879503/
Chiu HY, et al. Effects of intravenous and oral magnesium on reducing migraine: A meta-analysis of randomized controlled trials. Pain Physician. 2016;19(1):E97-112. https://pubmed.ncbi.nlm.nih.gov/26752497/
Thompson DF, Saluja HS. Prophylaxis of migraine headaches with riboflavin: A systematic review. J Clin Pharm Ther. 2017;42(4):394-403. https://pubmed.ncbi.nlm.nih.gov/33779525/
Long R, et al. Effectiveness of melatonin for prevention of migraine: A systematic review and meta-analysis. Front Pharmacol. 2020;11:570. https://pubmed.ncbi.nlm.nih.gov/32347977/
La Touche R, et al. The effects of aerobic exercise and resistance training in patients with migraine: A systematic review and meta-analysis. Cephalalgia. 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9563744/
Luedtke K, et al. A randomized controlled trial on the effectiveness of exercise on headache and cervicogenic headache. BMC Musculoskelet Disord. 2016;17:376. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556722/
Parohan M, et al. The effect of coenzyme Q10 supplementation on migraine: A meta-analysis. Nutr Neurosci. 2021;24(7):528-538. https://www.ncbi.nlm.nih.gov/pubmed/30428123