Life Extension Magazine®

Issue: Mar 2019

CoQ10 Targets the Cause of Migraine Headaches

CoQ10 blocks the transmission of migraine pain by reducing levels of a pain-creating compound. Human studies show that CoQ10 reduces the duration and frequency of migraines by more than 50%.

By Stephanie Carter

Migraines usually produce severe pain that can be difficult to prevent and treat with standard medications.

Migraine medications don't always work, don't work in all patients, and can have side effects.

In a 2018 published study, coenzyme Q10 (CoQ10) was shown to significantly reduce the frequency, severity, and duration of migraine headaches.1

This study showed that CoQ10 works by lowering levels of a peptide in the brain that is associated with pain and inflammation.1 It is called calcitonin gene-related peptide (CGRP).

Pharmaceutical companies are in the process of developing drugs that work by blocking this peptide. CoQ10 functions to block CGRP, and is available right now.

What you need to know

  • Migraine headaches are a major cause of disability, yet current treatments for preventing or treating the condition are not always effective and come with side effects.
  • A breakthrough 2018 study showed that CoQ10 supplements significantly reduced migraine frequency, severity, and duration.
  • CoQ10 accomplished this through significant reductions in blood levels of CGRP, a signaling molecule that originates in nerve endings and triggers pain in tissues surrounding the brain.
  • Lowering CGRP levels is a potent new way to prevent and treat migraines.
  • CoQ10 is well-tolerated and, unlike CGRP-targeted drugs, it is available now.

Migraine Prevention

Man looking into microscope

Intrigued by reports that migraine headaches and inflammation are correlated,2,3 and by studies showing that CoQ10 has certain anti-inflammatory properties,4,5 researchers began to dig deeper to see if CoQ10 was a possible treatment option for migraines.

About one-third of migraine subjects have a deficiency in CoQ10. And restoring CoQ10 levels to the normal range reduces headache frequency and disability.6

Human studies have shown that CoQ10 (at doses of 150-300 mg daily) can help migraine sufferers by:7-9

  • Preventing migraine occurrence.
  • Reducing number of days with migraine headache by more than 50%.
  • Reducing monthly frequency of headaches by more than 50%.
  • Being effective without any side effects.

The evidence favoring CoQ10's effectiveness and safety is so compelling that, as of 2015, the Canadian Headache Society included CoQ10 in its list of compounds receiving a strong recommendation for migraine prevention.10

More recently, a study released in 2018 confirmed CoQ10's role as a treatment for migraine headaches, and it also revealed important information about how it produces such impressive results.

CoQ10 Heals Migraine Pain

For this recent study, premenopausal women with migraines received either CoQ10 (400 mg daily) or a placebo.1

After three months, the women taking CoQ10 had significantly fewer migraine attacks than those receiving the placebo, an indication that CoQ10 can prevent migraines from occurring.

When a migraine did occur, it was shorter in duration and less severe.1

Getting good, clinical pain relief for a migraine is an important advance, considering how challenging the condition is to treat.

This study confirmed previous research about CoQ10's benefits for migraine relief. It also revealed two important mechanisms whose actions are responsible for these benefits.

The ubiquinone form of CoQ10 was used in this study. An enhanced form called ubiquinol enables far higher CoQ10 blood levels, thus enabling a lower dose of ubiquinol. Absorption can be further boosted by taking either form of CoQ10 with a meal that contains fat.

A New Target for Pain Control

Scientists talking

At the end of the study showing that CoQ10 has pain-reducing benefits, it was found that the CoQ10-supplemented subjects had lower blood levels of two underlying compounds related to migraines.

One was TNF-alpha, a well-known marker of inflammation.1

This indicates that one way CoQ10 combats migraines is by reducing inflammation. This makes sense, considering that studies have shown a connection between migraines and inflammation.2,3

The second compound lowered by CoQ10 is calcitonin gene-related peptide (CGRP). CGRP is produced in nerve cells, and is now recognized as a key mediator of pain signals.1,11,12

CGRP appears to be intimately connected to migraine headaches and CoQ10 lowers it, along with TNF-alpha.

A previous study showed that people who suffer from occasional migraines have elevated levels of CGRP in the blood and those with chronic migraines have still higher CGRP levels.12

How CGRP Works in the Brain

Pain is the most common reason people seek medical care, yet there's still a lot we don't understand about it.13

Migraine pain in particular is a difficult area in medicine. Available migraine treatments are imperfect: They don't work in all patients, they don't effectively prevent or treat all migraines, and many have undesirable side effects.

At present, it seems that migraines involve at least two factors:

  • Over-sensitization of the brain to otherwise normal stimuli, and
  • An inflammatory response generated within and around the brain itself.12

CGRP is released when the sensory nerve endings in the nerves and blood vessels that serve the face are stimulated. Once released, CGRP causes the blood vessels to dilate, including those in the highly pain-sensitive outer membrane covering the brain.11,12,14

Like other signaling molecules, CGRP binds to specific receptors in target tissues like blood vessels, which sets off the pain perception cascade.15

CGRP is so powerful that, injected intravenously, it provokes migraine attacks in 65% of people with known migraines.16

Fast Relief for Migraine Pain

The exciting news for migraine sufferers is that it's possible to prevent or treat migraine headaches by reducing or inhibiting CGRP release or binding to its receptors.

A 2017 meta-analysis pooled data from 13 studies that included more than 6,800 patients. This large review found that strategies that involved blocking, inhibiting, or reducing the production of CGRP were superior to a placebo in three key ways:

  • Relieving migraine pain within 2 hours (bringing fast relief).
  • Keeping the pain away for up to 24 hours (bringing lasting relief).
  • Blocking the heightened sensitivity to light and sound that is such a prominent feature of migraines.17

These data prompted pharmaceutical companies to develop CGRP-suppressing drugs. CoQ10, which works by a similar mechanism, has been available to Americans since 1983.

About Migraine Headaches
Woman holding head

Migraines are headaches with a neurological basis. We perceive them as debilitating head pain that is usually associated with alterations in sensory perception (such as the classic "aura" that precedes and accompanies migraines).15,20

Migraines produce severe pain that can be difficult to successfully prevent and treat. They are recognized in the Global Burden of Disease Study as one of the leading causes of disability and a serious impediment to a good quality of life.21

A true migraine headache is more than a "really bad" headache. It is characterized by severe, often one-sided pain, and can be accompanied by nausea and vomiting, and profound sensitivity to light and sound (there can be extreme sensitivity of other senses like smell and touch, as well).14

Migraine headaches can be episodic, meaning they develop unpredictably and with variable frequency. Chronic migraines produce headaches at least 15 days a month, at least 8 of which meet criteria for migraine.20

Today's migraine treatment mainstay is the triptan family of drugs. But these are considered first-line for treating an acute migraine attack, not for preventing one. And they are not useful against chronic migraines.22,23

The discovery of CGRP and its role in migraine headache production is therefore a breakthrough in migraine science.

And the finding that CoQ10 supplementation suppresses CGRP is a breakthrough in migraine prevention and treatment.

The Future of Migraine Treatment

Migraine drugs that work by inhibiting CGRP are being actively investigated.

These drugs use monoclonal antibodies to bind to CGRP or its receptor and prevent their connection. Doing so breaks the CGRP-induced pain cycle.18

Four drug companies are close to releasing their own versions of anti-CGRP drugs.18 These drugs appear to be effective, but they come with some major downsides.

They are costly, must be injected, and can cause unwanted side effects like dry mouth, constipation, nausea, memory loss, numbness, and weight gain.18,19 Plus, it will be years before they are widely available.

Fortunately, there's no need to await costly and uncertain CGRP-lowering prescription drugs.

CoQ10 safely lowers blood levels of CGRP, and it is available right now.

Summary

CoQ10 can help prevent migraine headaches by breaking the cycle of inflammation and neural over-sensitization that contributes to their development.

CoQ10 blocks pain transmission by reducing levels of the pain-mediating compound CGRP.

A 2018 study showed that CoQ10 reduces headache pain, frequency, and duration.

Migraine sufferers now have another safe, scientific, and affordable option for preventing and treating their pain.

CoQ10's ability to lower CGRP levels is an important discovery for migraine sufferers because it reveals a potent new way to prevent and treat the condition.

Doses of 150-400 mg daily of CoQ10 have been shown to effectively lower CGRP and prevent migraines.

If people choose the more readily absorbable ubiquinol form of CoQ10, they can probably reduce this daily dose by half, especially if they take it with a meal that contains some fat.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

  1. Dahri M, Tarighat-Esfanjani A, Asghari-Jafarabadi M, et al. Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers. Nutr Neurosci. 2018 Jan 3:1-9.
  2. Malhotra R. Understanding migraine: Potential role of neurogenic inflammation. Ann Indian Acad Neurol. 2016 Apr-Jun;19(2):175-82.
  3. Ramachandran R. Neurogenic inflammation and its role in migraine. Semin Immunopathol. 2018 May;40(3):301-14.
  4. Abdollahzad H, Aghdashi MA, Asghari Jafarabadi M, et al. Effects of Coenzyme Q10 Supplementation on Inflammatory Cytokines (TNF-alpha, IL-6) and Oxidative Stress in Rheumatoid Arthritis Patients: A Randomized Controlled Trial. Arch Med Res. 2015 Oct;46(7):527-33.
  5. Hernandez-Camacho JD, Bernier M, Lopez-Lluch G, et al. Coenzyme Q10 Supplementation in Aging and Disease. Front Physiol. 2018;9:44.
  6. Hershey AD, Powers SW, Vockell AL, et al. Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache. 2007 Jan;47(1):73-80.
  7. Rozen TD, Oshinsky ML, Gebeline CA, et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia. 2002 Mar;22(2):137-41.
  8. Sandor PS, Di Clemente L, Coppola G, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology. 2005 Feb 22;64(4):713-5.
  9. Shoeibi A, Olfati N, Soltani Sabi M, et al. Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial. Acta Neurol Belg. 2017 Mar;117(1):103-9.
  10. Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012 Mar;39(2 Suppl 2):S1-59.
  11. Kuzawinska O, Lis K, Cessak G, et al. Targeting of calcitonin gene-related peptide action as a new strategy for migraine treatment. Neurol Neurochir Pol. 2016 Nov - Dec;50(6):463-7.
  12. Slavin M, Bourguignon J, Jackson K, et al. Impact of Food Components on in vitro Calcitonin Gene-Related Peptide Secretion-A Potential Mechanism for Dietary Influence on Migraine. Nutrients. 2016 Jul 1;8(7).
  13. Available at: https://www.merckmanuals.com/professional/neurologic-disorders/pain/overview-of-pain. Accessed November 29, 2018.
  14. Akerman S, Romero-Reyes M, Holland PR. Current and novel insights into the neurophysiology of migraine and its implications for therapeutics. Pharmacol Ther. 2017 Apr;172:151-70.
  15. Russo AF. Calcitonin gene-related peptide (CGRP): a new target for migraine. Annu Rev Pharmacol Toxicol. 2015;55:533-52.
  16. Guo S, Christensen AF, Liu ML, et al. Calcitonin gene-related peptide induced migraine attacks in patients with and without familial aggregation of migraine. Cephalalgia. 2017 Feb;37(2):114-24.
  17. Hong P, Liu Y. Calcitonin gene-related peptide antagonism for acute treatment of migraine: a meta-analysis. Int J Neurosci. 2017 Jan;127(1):20-7.
  18. Available at: https://www.medscape.com/viewarticle/886068#vp_1. Accessed 9 April, 2018.
  19. Available at: https://www.webmd.com/migraines-headaches/news/20180517/fda-approves-first-of-new-migraine-drugs. Accessed November 29, 2018.
  20. Schwedt TJ. Chronic migraine. BMJ. 2014 Mar 24;348:g1416.
  21. Hou M, Xing H, Cai Y, et al. The effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor on migraine: a systematic review and meta-analysis. J Headache Pain. 2017 Dec;18(1):42.
  22. Al-Quliti KW, Assaedi ES. New advances in prevention of migraine. Review of current practice and recent advances. Neurosciences (Riyadh). 2016 Jul;21(3):207-14.
  23. Fischer M, Frank F, Wille G, et al. Triptans for Acute Migraine Headache: Current Experience With Triptan Use and Prescription Habits in a Tertiary Care Headache Outpatient Clinic: An Observational Study. Headache. 2016 Jun;56(6):952-60.

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