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Natural Agents Offer Relief from the Misery of Migraines

February 2004

By Romy Fox


Why feverfew helps prevent migraines remains unknown. Some researchers attribute the herb’s anti-migraine properties to its parthenolide, which may hinder the inflammatory process,19 or to the release of serotonin from certain white blood cells and platelets, which in turn can reduce the frequency and severity of migraines by keeping the blood vessels properly toned.20 Other substances in feverfew may interfere with the actions of arachidonic acid and histamine, which can contribute to migraine pain and other symptoms.21

Feverfew has been approved in Britain and Canada as a treatment for migraines, with a generally recommended dose of 100 mg per day.

Butterbur for Migraines
Butterbur (Petasites hybridus) is a shrub native to Europe and parts of Asia and Africa. For the past 30 years, it has been prescribed to migraineurs in Germany. Butterbur contains petasin and isopetasin,22 which are believed to slow the body’s production of leukotriene. With less leukotriene present, blood vessels are less likely to become inflamed and migraines less likely to develop.

A standardized extract of butterbur called Petadolex® was used in two randomized, double-blind, placebo-controlled studies to test whether butterbur could prevent migraines. In the first study, 60 migraineurs were divided into two groups. For 12 weeks, one group received 100 mg of Petadolex® a day, the other a placebo. By the end of the first month, those taking the butterbur extract reported significantly fewer migraine headaches compared to those taking the placebo. By the third month, the butterbur group had 60% fewer migraine attacks than did the control group. Migraine-related symptoms also were reduced, and no significant side effects were reported among those taking the Petadolex®.

The second study, involving 233 migraineurs, produced equally encouraging results.22 The volunteers received either 100 mg of Petadolex®, 150 mg of Petadolex®, or a placebo every day for 16 weeks. Those taking 150 mg of Petadolex® daily saw significantly fewer migraines compared to the placebo group, with mild gastrointestinal problems being the only reported side effect. The study results suggest that 75 mg of butterbur extract taken twice a day with food may be the optimal dosage.

Other Intriguing Therapies
While physicians continue to explore how magnesium, riboflavin, feverfew, and butterbur work to counteract migraines, several other therapies also are under study.

Glucosamine. Doctors at Canada’s Brampton Pain Clinic studied 10 people. All suffered migraines or migraine-like headaches and none had been helped by previous standard treatments.23 After they took glucosamine for 4-6 weeks, the volunteers reported a drop in the number and intensity of migraines. The researchers theorize that glucosamine works through white blood cells called mast cells to boost the production of heparin, which helps to reduce blood clotting, thus reducing nerve-mediated inflammation and pain. How much glucosamine is required to prevent migraines is unknown, but the therapeutic dose may be similar to that used to treat osteoarthritis (approximately 1,800 mg per day).

Coenzyme Q10 (CoQ10). This vitamin-like substance may aid migraineurs by stimulating the mitochondria to produce more energy. A 2002 study published in the journal Cephalgia reported on 32 migraine patients treated with a daily dose of 150 mg of CoQ10 for four months.24 By the study’s end, the average number of migraine attacks per month fell from 4.85 to 2.81, and CoQ10 did not trigger any reported side effects. If the results of this preliminary study are confirmed by double-blind studies, 150 mg per day of CoQ10 may become the recommended dose.

Melatonin. Secreted by the pineal gland at night to aid in sleep, this hormone also may play a role in the genesis of migraines. French researchers noted abnormal melatonin levels in the blood of four of six women who suffer from migraines (compared to nine healthy people serving as controls).25 The scientists theorized that problems with the pineal gland may be responsible for migraines in some people, thus explaining why melatonin may help reduce the incidence of migraines.

According to the American Migraine Study II conducted by the National Headache Found-ation, migraine headaches are underdiagnosed and undertreat-ed.26 Despite new understanding of the disease and new “medications designed specifically for the treatment of migraine, many patients continue to experience needless pain and disability,” the study reported.

Some 28 million Americans suffer migraines, which means you can find a migraineur in one of every four households. While standard medications are helpful, millions may find additional relief in natural, readily available substances such as magnesium, riboflavin, feverfew, butterbur, glucosamine, CoQ10, and melatonin.


1. Educational Resources: NHF Headache Fact Sheet page. National Headache Foundation web site. Available at: http://www.headaches. org/consumer/generalinfo/factsheet.html. Accessed November 25, 2003.

2. CoQ10’s possible new target: migraines. Life Extension magazine, April 2003:28.

3. Khosh F. Natural approach to migraine headaches. Townsend Letter for Doctors and Patients, Aug-Sep 2002.

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7. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium sulphate relives migraine attacks in patients with low serium ionized magnesium levels: a pilot study. Clin Sci (Lond) 1995 Dec;89(6):633-6.

8. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium sulfate rapidly alleviates headaches of various types. Headache 1996(Mar);36(3):154-60.

9. Peikert A, Wilimzig C, Kohne-Volland R. Prophylaxis of migraine with oral magne- sium: results from a prospective, multi-cen- ter, placebo-controlled and double-blind randomized study. Cephalagia 1996 Jun;16(4):257-63.

10. Facchinetti F, Sances G, Borella P, Genazzani AR, Nappi G. Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium. Headache 1991 May;31(5):298- 301.

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12. Schoenen J, Lenaerts M, Bastings E. High- dose riboflavin as a prophylactic treatment of migraine: results of an open pilot study. Cephalgia 1994 Oct;14(5):328-9.

13. Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized con trolled trial. Neurology 1998 Feb;50(2):466- 70.

14. Southon S, Bailey Al, Wright AJ, Belsten J, Finglas PM. Mircronutrient undernutrition in British schoolchildren. Proc Nutr Soc 1993 Feb;52(1):155-63.

15. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophy- lactic treatment of migraine. Br Med J (Clin Res Ed) 1985 Aug 31;291(6495):569-73.

16. Murphy JJ, Heptinstall S, Nitchell JR. Randomized double-blind placebo-con- trolled trial of feverfew in migraine preven- tion. Lancet 1988 Jul 23;2(8604):189-92.

17. Prusinski A, Durko A, Niczyporuk-Turek A. Feverfew as prophylactic treatment of migraine. Neurol Neurochir Pol 1999;33 Suppl 5:89-95.

18. Ernst E, Pittler MH. The efficacy and safety of feverfew (Tanacetum parthenium L): an update of a systematic review. Public Health Nutr 2000 Dec;3(4A);509-14.

19. Cutlan AR, Bonilla LE, Simon JE, Erwin JE. Intra-specific variability of feverfew: correla- tions between parthenolide, morphological traits and seen origin. Planta Med 2000 Oct;66(7):612-7.

20. Mauskop A, Fox B. What Your Doctor May Not Tell You About Migraines. New York: Warner Books; 2001:79.

21. Mauskop A, Fox B. What Your Doctor May Not Tell You About Migraines. New York: Warner Books; 2001:52.

22. Brown DJ. Standardized butterbur extract Petadolex®—herbal approach to migraine prophylaxis. Townsend Letter for Doctors and Patients, Oct 2002.

23. Russell AL, McCarty MF. Glucosamine for migraine prophylaxis? Med Hypotheses 2000 Sep;55(3):195-8.

24. Rozen TD, Oshinsky ML, Gebeline CA, et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalagia 2002 Mar;22(2):137-41.

25. Claustrat B, Brun J, Geoffriau M, Zaidan R, Mallo C, Chazot G. Nocturnal plasma mela- tonin profile and melatonin kinetics during infusion in status migrainosus. Cephalagia 1997 Jun;17(4):511-7.

26. New Results Available from the American Migraine Study II [press release]. Chicago: National Headache Foundation, February 22, 2000.