If you are experiencing migraine headaches, you might benefit from trying lifestyle modifications, alternative therapies and/or herbal supplements.

Lifestyle Modifications

Eat every three to four hours.

Eating regularly helps to prevent low blood sugar. Small drops in blood sugar levels can trigger headaches. Do not skip meals. Try eating multiple small meals at least every three to four hours.

Stay hydrated.

Drink a lot of water, juice or milk. You will know you are drinking enough when your urine is pale yellow or clear in color. Limit the number of carbonated and/or caffeinated beverages you drink.

Exercise.

Exercise is helpful for relieving stress. Aerobic exercise might help prevent migraines. Remember to warm up before beginning any vigorous exercise. Vigorous exercise might lead to or worsen a migraine. Vigorous aerobic activity means you’re breathing hard and fast, and your heart rate has increased. If you’re working at this level, you won’t be able to say more than a few words without pausing for a breath. Examples include: jogging, swimming laps, riding a bike, tennis and basketball.

Sleep.

Keep a regular sleep schedule. Keep a consistent bedtime and awaking time, even on the weekends.

Be smoke-free.

Cigarette smoke may contribute to headache disorders. Home environments should be smoke-free. Patients should discontinue cigarette smoking.

Limit medicines that contain estrogen.

Medicines that contain estrogen, such as oral contraceptives (birth control) and hormone replacement therapy, may trigger migraines or make them worse. Talk to your health care provider about whether you should stop taking these types of medicines or reduce the dosage.

Alternative Therapies

Hot and Cold

Migraines are related to the pattern of blood circulation in your head. Using hot and cold therapies can help in regulating blood circulation. Taking a hot bath or using a warm pack on your neck will open up those vessels. Using a cold pack on your head will help narrow those vessels. You may find comfort in trying to change the temperature to what feels best for you. Lying in a dark room with an ice pack on your neck may help prevent a migraine you feel coming on.

Biofeedback

Biofeedback training teaches you to monitor and control physical responses to stress, such as muscle tension. This is achieved by using special instruments for feedback to help you train your mind to have control over certain body functions normally considered involuntary. Please ask your health care provider for a referral. 

Relaxation Therapy/Guided Imagery

Learning to slowly relax and release muscle tension may be helpful. This can be achieved through progressive muscle relaxation, visualization, and deep breathing. Please ask your health care provider for a referral.

Cognitive Behavioral Therapy (CBT)

CBT teaches you how to identify and cope with stressors in your life. Once stressors are identified, you can understand how your thoughts and behavior patterns may affect your symptoms. You may also learn how to change the way your body responds to anticipated pain. Please ask your provider for a referral.

Acupuncture

Acupuncture is a Chinese medicine technique that uses thin needles to stimulate points on the body that are believed to be aligned with energy pathways in the body. In acupuncture, needles are inserted into points along the pathways where the energy flow may be blocked.
This allows the energy to flow in a balanced state. Some practitioners in the United States use the acupuncture points as places to stimulate nerves, muscles and connective tissue. This stimulation appears to boost the activity of your body’s natural painkillers and increase blood flow. It is important that you go to a certified practitioner for this therapy. Please ask your provider for a referral.

Herbs and Supplements

Manufacturers of herbal remedies and dietary supplements do not need Food and Drug Administration (FDA) approval to sell their products. These products can affect the body’s chemistry, and they have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products. You should always check with your health care provider or pharmacist before using any herbal remedies or dietary supplements.

Riboflavin (Vitamin B2)

In high doses of up to 400 mg (which is 200 times the recommended dietary allowance), vitamin B2 may help prevent migraine headaches. Vitamin B2 is generally safe. Some people taking high doses may experience diarrhea. Excess vitamin B2 is passed out through the urine. Further studies are recommended to look at the effects. Always check with your health care provider or pharmacist before using any herbal remedies or dietary supplements.

Magnesium Supplements

Magnesium helps relax blood vessels. Some patients report that magnesium supplements provide some migraine relief. The average dose is 200-500 mg a day. In high or excessive doses, magnesium can cause serious toxic reactions. Always check with your health care provider or pharmacist before using any herbal remedies or dietary supplements.

Fish Oil

Fish oil has been found to be helpful for people who suffer from migraines. Fish oil contains omega-3 fatty acids; these have anti-inflammatory and nerve-protecting properties. Omega-3 fatty acids can be found in oily fish, such as salmon, mackerel, trout, herring, scallops, oysters, clams and sardines. They can also be obtained in over-the-counter supplements of specific omega-3 compounds (DHA-EPA). General doses: 15-20 grams of fish oil (30% EPA) a day; 2 ounces of fish per day; or two 8-ounce fish meals a week. Always check with your health care provider or pharmacist before using any herbal remedies or dietary supplements.

Ginger

Ginger may help decrease migraine headache pain and the frequency of migraines. Ginger may be used by children safely; it has no side effects and can be eaten in powder or fresh form, as long as quantities are not excessive. Do not exceed 1 gram of dried ginger or two cups of ginger tea. Ginger is also effective for relieving nausea. Always check with your health care provider or pharmacist before using any herbal remedies or dietary supplements.

Butterbur

Butterbur is a perennial shrub found throughout Europe and in parts of Asia and North America. Research suggests it can help prevent migraine headaches in some people. Limit use to commercially available products that are free of pyrrolizidine alkaloids, which are generally believed to be well-tolerated. Long-term safety (beyond 12-16 weeks of use) is not well studied. Use caution if a patient has a known allergy/hypersensitivity to Petasites hybridus or other plants from the Asteraceae/Compositae family, including ragweed, marigolds, daisies and chrysanthemums.

Feverfew

Feverfew is an herb that has been traditionally used to treat fevers, although this effect has not been well studied. Feverfew is most commonly taken by mouth to prevent migraine headache. Feverfew might cause allergic reactions in people allergic to chrysanthemums, daisies, marigolds or other members of the Compositae family, including ragweed. There are multiple reports of allergic skin rashes after contact with feverfew. Tests suggest that feverfew affects blood platelets and, in theory, might increase the risk of bleeding.

Resources

National Headache Foundation
Information on headaches and migraines.
www.headaches.org

American Headache Society
Includes information on migraines, diary cards, nonpharmacological management, and trigger avoidance.
www.achenet.org

American Academy of Neurology (AAN)

Information on neurologic disorders from various sources.
www.aan.com/patients

National Institute of Neurological Disorders and Stroke
Health information on various neurological disorders.
www.ninds.nih.gov

Clinical Trials
Find clinical trials and research.
www.clinicaltrials.gov

This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team.