he treatment and management of migraines is challenging because the underlying causes are not fully understood. However, patients with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episode show reduced mitochondrial energy transfer which causes migraine-like headaches. Riboflavin, vitamin B2, is effective at prophylactically treating these headaches, which suggests that it may be an effective treatment for migraine sufferers. Indeed reduced energy metabolism has been suggested to be a cause of both aura and non-aura migraines. Riboflavin might be helpful because it is incorporated into the flavoproteins; flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD). The flavoproteins act as co-factor in a number of key steps in energy metabolism and are involved in the mitochondrial electron transport chain. Research to date shows a possible beneficial effect of riboflavin in the treatment in migraine sufferers, supporting the energy production hypothesis.
For example, researchers1 investigated the effects of riboflavin supplements at 200 or 400 mg/d in 41 paediatric and adolescent sufferers for 3, 4 or 6 months. Supplementation reduced the frequency and intensity of attacks significantly. In the follow-up interviews, 68.4 % of the subjects reported a 50 % or greater reduction in attack frequency and a 21 % or greater reduction in attack intensity. The researchers found no significant difference between the two doses used. In another study2, researchers investigated the effects of 400 mg/d riboflavin in a migraine outpatient clinic. The riboflavin treatment significantly reduced the frequency of attacks from 4 d/month to 2 d/month after 3 months. This decrease in frequency decrease concomitant drug use. Although both of these studies were not placebo controlled, they demonstrate that riboflavin may be beneficial in the treatment of migraines. No side effects were reported, and riboflavin is non-toxic to humans.
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