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Complementary and Alternative Approaches to Chronic Daily Headache: Part III—Nutraceuticals

  • Laura Granetzke
  • Brielle Paolini
  • Rebecca Erwin Wells
Chapter

Abstract

Almost one-third of adults with severe headaches/migraines report using nutraceuticals. Many may seek herb/supplements for their “natural” and “safe” profile, but they have limited FDA oversight and are not always impartially tested. Understanding the terminology and regulatory oversight of non-pharmacologic products can help providers appropriately treat and counsel patients about these options. Few studies have evaluated the benefit of nutraceuticals specifically for chronic daily headache. In this chapter, the research evidence for nutraceuticals for primary headache disorders is described. If not available, the research presented for headache can be extrapolated for consideration in the treatment of chronic daily headache. Several supplements have Level B evidence of efficacy according to the 2012 American Headache Society and the American Academy of Neurology guidelines, including feverfew (studied dose, 50–300 mg bid; 2.08–18.75 tid of MIG-99), riboflavin (studied dose, 400 mg daily), and magnesium (studied dose, 600 mg trimagnesium dicitrate daily). Coenzyme Q10 (studied dose 100 mg tid) was given Level C evidence. Melatonin, vitamin D, and Ginkgo biloba have limited evidence of potential efficacy for headache. Although Level A evidence exists for Petasites (butterbur), it is not currently recommended secondary to potential for liver toxicity. Homeopathic treatments have little evidence to support their use in chronic daily headache. More research is needed to further clarify benefits of supplements for chronic daily headache.

Keywords

Chronic daily headache Chronic migraine Chronic tension-type headache Nutraceutical Herbs Supplements Feverfew Riboflavin Magnesium Coenzyme Q10 Magnesium Vitamin D 

Notes

Acknowledgments

Dr. Wells is supported by the National Center for Complementary and Integrative Health of the National Institutes of Health under Award Number K23AT008406. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We gratefully acknowledge the editorial assistance of Karen Klein, MA, in the Wake Forest Clinical and Translational Science Institute, funded by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001420. We also thank Mark McKone, Librarian at Carpenter Library, Wake Forest School of Medicine, for his help with the use of Zotero. We are appreciative of the help from Nakiea Choate from the Department of Neurology at Wake Forest Baptist for her administrative support.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Laura Granetzke
    • 1
  • Brielle Paolini
    • 2
  • Rebecca Erwin Wells
    • 1
  1. 1.NeurologyWake Forest School of MedicineWinston-SalemUSA
  2. 2.Wake Forest School of MedicineWinston-SalemUSA

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