A pooled analysis of 20 double-blind trials compared vitamins and supplements for migraine prevention. In adults, riboflavin 400 mg showed the most consistent reduction in monthly attacks, the researchers report.
Source: Pooled analysis of studies, 20 double-blind randomized trials, 1,829 people randomized (1,600 analyzed), adults and children; 10 adult trials informed the main attack-frequency analysis. It combines earlier studies, so its strength depends on the studies it pooled.
What was found
The researchers report that riboflavin (vitamin B2) 400 mg cut adult migraine attacks by about 1.95 per month compared with placebo (95% confidence interval 1.49 to 2.42 fewer). They rated this moderate certainty.
Larger point estimates appeared for vitamin B12 500 μg (2.50 fewer attacks per month), vitamin B6 80 mg (2.33 fewer) and vitamin D3 (2.29 fewer). The B12 and B6 results came from single small trials and the vitamin D3 result from two small trials. All were low to very low certainty.
For the share of people whose attacks fell by at least half, coenzyme Q10 (CoQ10) 300 mg was the only treatment with a statistically significant advantage in adults. The authors rated this very low certainty.
CoQ10 400 mg shortened attacks by about 3.3 hours and lowered pain severity, both rated low certainty. Magnesium showed no detected benefit on any outcome. Side effects were reported most often with magnesium, but the authors say these figures are descriptive and not a comparison.
How it was done
The team searched major medical databases up to March 2026 for double-blind randomized trials of vitamins or nutraceuticals for migraine prevention. They used a network meta-analysis, which compares several treatments at once, including pairs never tested head to head.
The main outcome was monthly attack frequency. The main analysis covered adults only, and trials in children were summarized separately. Certainty of the evidence was rated with a standard framework.
What it does not show
Several treatments were judged on only one or two small trials, so their estimates are imprecise and low in certainty. The responder results were limited by sparse data and should be read cautiously.
Riboflavin 100 mg and 200 mg gave no adult attack-frequency data. An earlier signal for riboflavin 200 mg came from a trial in children.
The authors say larger, standardized trials are needed to confirm how the treatments compare and how safe they are.
What happens next
The authors call for larger, standardized and adequately powered trials to confirm comparative efficacy and safety.
Where this fits
The result applies to adults in the main analysis; trials in children were treated separately. The review ranks riboflavin highest in certainty, while estimates for B6, B12, vitamin D3 and CoQ10 rest on few small trials. Readers can compare the doses studied, such as riboflavin 400 mg, with the doses on their own supplement labels, and check any supplement against their medicines.
Read more: Supplement and medication interactions
Who was talking about it
- Headache on journal (2026-11-05): Headache published a network meta-analysis ranking vitamins and nutraceuticals for migraine prevention, finding riboflavin 400 mg the most reliable option in adults. See the post
The source
This is news, reported from the source above. It is not medical advice and not a recommendation. Talk to your doctor or pharmacist before you change any medicine or supplement.